UNIVERSITY  OF  CALIFORNIA 

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Rush  Medical  College 
Library 


A  VERY  YOUNG  OVUM 
IN  SITU 


PROF.Cfc.l  LEOPOLD 


GEHEIMER  MEDIZINALRAT,  DIRECTOR  OF  THE  ROYAL  GYNECOLOGIC 
CLINIC  AND  SCHOOL  FOR  MIDWIFERY.     MEMBER  OF  THE 
ROYAL  MEDICAL  BOARD  OF  DRESDEN. 


COMPRISING  THE  FOURTH  VOLUME  OF  THE  "ARBEITEN 
AUS  DER  FRAUEN  KLINIK  IN  DRESDEN." 


WITH  SIXTEEN  LITHOGRAPHIC  PLATES 


AUTHORIZED  ENGLISH  TRANSLATION 

BY 

W.  H.  VOGT,  M.  D. 

GYNECOLOGIST  AND  OBSTETRICIAN  TO  THE  LUTHERAN  HOSPITAL 
ST.  Louis,  MISSOURI 


C.  V.  MOSBY  CO. 

ST.  LOUIS 
1907 


Privilege  of  Copyright  reserved  by 

S.  HIRZEL,  Leipzig,  Germany, 

Oct.  10th,  1906.     Act  of  March  3rd,  1905. 


CONTENTS 

PAGE 

Introduction  -         -         5-g 

Consideration   of  the  Reconstruction  of  the  Ovum  From 

Section  1  to  160  -     10-33 

CHAPTER 

I.  The  Mucosa  Elevation,  which  Harbors  the  Ovum, 

and  the  Decidua  Vera  -     -     34-42 

II.  The  Embedding  of  the  Ovum.     The  Capsularis. 

The  Fibrinous  Cover  ("Gewebspilz"  of  Peters)  42-51 

III.  The    "Eianlage"    and    the     Ovular     Chamber. 

("Eikammer")  51-54 

IV.  The  Trophoblast  and  its  Surrounding  Blood  Spaces. 

The  Intervillous  Circulation  54-64 

V.  The  Syncytium  64-66 

Explanation  of  Figures 67-69 


101276 


INTRODUCTION. 


The  Ovum  which  forms  the  subject  of  this  investigation  orig- 
inates from  a  young  woman  who  committed  suicide  with  phos- 
phorus. The  post  mortem  examination  was  performed  by  -Ober- 
medizinalrat  Prof.  Dr.  Schmorl,  in  the  pathological  institute .  of 
the  Friedrichsstaedter  hospital  in  Dresden. 

The  fact  that  this  woman  had  committed  suicide  suggested 
the  possibility  of  a  pregnancy  and  for  that  reason  the  anterior 
wall  of  the  uterus  was  split  and  the  specimen  carefully  hard- 
ened, first  in  formalin  and  then  in  increasing  strengths  of  alco- 
hol. Although  repeated  and  careful  examinations  of  the  endo- 
metrium  were  made  with  a  magnifying  glass,  no  ovum  could 
be  detected.  Still  the  greatly  swollen  mucous  membrane  which 
was  divided  into  irregular  areas  by  furrows,  as  we  are  accus- 
tomed to  see  in  a  pregnant  uterus,  was  conspicuous  and  induced 
us  to  make  repeated  examinations  during  the  process  of  harden- 
ing. Finally  a  small  spot  was  detected,  lighter  than  the  sur- 
rounding tissue,  situated  on  the  posterior  wall  of  the  corpus  uteri 
a  little  below  its  center  and  immediately  above  a  deep  furrow. 
In  order  to  study  this  small  spot  more  carefully,  a  square  piece 
of  mucous  membrane  about  1  cm.  long,  with  its  underlying  mus- 
cularis  was  excised  and  after  further  hardening  by  the  labora- 
tory assistant,  Mr.  Ernst  Thomas,  cut  into  a  continuous  series  of 
sections,  five  microns  thick  and  then  stained  in  haematoxylin- 
eosin.  The  middle  one  hundred  and  sixty  sections  comprised  a 
very  small  ovum  whose  measurements  were  1.4  mm.  long  0.9 
mm.  deep  and  0.8  mm.  wide,  an  ovum  about  the  size  of  that 
described  by  Peters,  however  a  trifle  smaller,  its  length  being 
0.2  mm.  shorter  than  that  of  Peters,  which  measured  1.6  mm.  in 
length,  0.8  mm.  in  depth  and  0.9  mm.  in  breadth.  No  information 
could  be  obtained  concerning  the  time  of  the  last  or  first  missing 
menstruation.  Hence  it  seems  useless  to  attempt  any  estimate  of 
the  age  of  this  ovum.  In  the  following  pages  it  is  intended  to 
compare  the  results  of  the  microscopic  examinations  with  those 
of  Peters,  since  this  one  and  the  one  described  by  him  are  the 
two  smallest  and  youngest  human  ova  ever  observed. 

5 


D  INTRODUCTION. 

The  accompanying  plates  were  carefully  drawn  by  the  artist, 
Richard  Scholz,  exactly  true  to  nature  and  without  any  attempt 
to  obtain  a  diagramatic  effect. 

I  wish  to  thank  the  artist,  as  well  as  the  publisher,  for  the  ex- 
cellent reproduction  of  these  figures  and  for  the  valuable  ser- 
vices they  have  thereby  rendered  science. 

There  will  be  considered: 

1st.     The  Decidua  Vera. 

2nd.  The  Implantation  of  the  Ovum  with  the  formation  of 
the  capsularis  and  the  fibrinous  covering,  which  lies  over  the 
ovum  on  the  mucous  membrane.  ("Gewebspilz"  of  Peters.) 

3rd.     The  "Eianlage"  and  the  Ovular  Chamber  "Eikammer." 

4th.     The  Trophoblast  and  its  surrounding  blood  spaces. 

5th.    The  Syncytium. 

A  germinal  plate  which  was  found  in  Peters'  specimen  could 
not  be  discovered  in  any  of  the  sections  of  this  new  ovum. 
Whether  its  absence  be  possibly  due  to  the  general  phosphorus 
poisoning  must  remain  an  open  question  until  more  specimens 
of  such  an  early  stage  are  obtained.  It  must  be  remembered 
that  the  woman  from  whom  the  Peters  ovum  was  obtained,  also 
committed  suicide,  but  with  caustic  potash,  which  is  capable  of 
producing  a  very  acute  hyperemia  of  the  mucous  membrane  of 
the  pelvic  organs. 

Some  of  the  ova  described  by  Marchand,  Rossi  Doria,  Graf 
von  Spec,  Heukelom,  Mertens,  etc.,  can  hardly  be  pronounced 
normal  specimens  free  of  objections.  The  indications  for  the 
post  mortem  in  such  instances  will  necessarily  be  either  a  suicide 
or  an  acute  illness  caused  by  poisoning  or  some  intercurrent  dis- 
ease (such  as  pneumonia,  burns,  etc.),  or  a  disease  of  the  sexual 
organs  necessitating  a  removal  of  the  uterus.  All  of  these  con- 
ditions, especially  in  the  early  stages  of  pregnancy,  will  hardly 
ever  fail  to  lead  to  some  changes  in  the  circulatory  apparatus  of 
the  uterus.  Nevertheless  some  portions  of  both  the  uterus  or  the 
ovum  may  be  found  in  a  very  satisfactory  state  of  preservation. 

Of  the  three  young  ova  described  by  Marchand,  the  first  had 
a  defective  fibrinous  capsule,  supposedly  injured  during  a  curet- 
age.  The  second  was  infiltrated  with  blood  and  yet  Marchand 
did  not  hesitate  to  investigate  these  defective  specimens,  to  study 
such  difficult  problems  as  the  trophoblast  and  the  syncytium  and 
finally  drew,  although  with  great  precaution,  certain  conclu- 
sions. 

In  order  to  satisfy  myself  of  the  value  of  this  specimen  I  sub- 
mitted several  sections  to  my  esteemed  colleagues,  Obermedizin- 
alrat  Prof.  Dr.  Schmorl  and  Prof.  Graf  von  Spec  in  Kiel,  whom 


INTRODUCTION.  t 

I  wish  to  thank  for  a  careful  examination  of  these  slides.  Prof. 
Graf  von  Spec  did  not  question  in  the  least  the  good  histological 
preservation  of  this  specimen.  He  called  attention  to  the  great 
scientific  value  of  this  new  ovum  and  pointed  out  the  frequent  oc- 
currence of  a  congested  area  surrounding  the  seat  of  implantation 
in  this  stage  of  development.  The  ovum  of  Peters,  which  may 
be  one-half  to  one  day  older,  also  shows  this  marked  congestion 
of  the  blood  vessels  in  the  immediate  neighborhood  of  the  ovum. 

We  must  bear  in  mind  that  during  or  immediately  after  the 
penetration  of  the  ovum  into  the  endometrium,  a  pronounced  af- 
flux of  blood  is  a  natural  consequence.  Regarding  this  only  a 
study  of  other  very  young  ova,  which  can  be  expected  in  the 
near  future,  will  throw  more  light  on  this  problem,  until  then 
it  seems  permissible  to  disregard  the  objection  that  the  poison- 
ing with  phosphorus  might  interfere  with  the  reliability  of  the 
histological  picture  presented  by  our  specimen.  At  any  rate  it 
must  be  emphasized,  that  this  latest  ovule,  exactly  like  that  of 
Peters',  the  one  demonstrated  by  Graf,  von  Spec  in  Kiel,  and 
the  very  small  ovum  described  by  me  in  my  atlas  ("Uterus  und 
Kind")  were  found  in'  situ  embedded  in  an  uninjured  mucous 
membrane  in  a  perfect  condition. 

The  detailed  discussion  in  the  following  chapter  will  be  simpli- 
fied by  a  general  preliminary  consideration  of  the  mucous  mem- 
brane elevation  which  harbors  the  ovum.  This  is  done  in  the 
following  table,  which  contains  only  the  findings  pertaining  to 
this  point  in  the  sections  1  to  160. 

This  table  shows  plainly  that  the  fibrin  coat  ("Gewebspilz"  of 
Peters)  which  covers  the  top  of  the  mucous  membrane  elevation 
("Schleimhauthuegel")  consists  of  two  adjoining  portions.  The 
one  we  can  follow  from  sections  10  to  68,  where  it  has  almost  dis- 
appeared. The  second  portion  begins  in  section  75  and  disap- 
pears again  completely  in  section  103.  In  a  similar  manner  the 
glands  and  the  blood  vessels  can  be  followed.  This  preliminary 
general  consideration  furnishes  a  good  picture  of  the  enormous 
number  of  glands  and  capillaries  and  shows  how  the  glands 
gradually  are  crowded  out  through  the  dilatation  and  rupture 
of  the  capillaries  in  the  surrounding  tissue. 

This  general  survey  alone  demonstrates  the  fact  that  the  mi- 
nute ovum  is  completely  encircled  by  free  blood  spaces. 

It  affords  me  great  pleasure  to  say  a  few  words  regarding  the 
translation  of  my  book,  which  Dr.  Vogt  has  so  kindly  under- 
taken. A  few  years  ago  Dr.  Vogt  was  a  pupil  of  mine  who  for 
many  months  assisted  me  both  in  theoretical  and  practical  work. 
I  shall  owe  to  this  translation  a  widespread  acquaintance  with 


8  INTRODUCTION. 

this  highly  interesting  specimen,  herein  described,  among  my 
many  friends  and  former  pupils,  as  well  as  my  colleagues  on  the 
other  side  of  the  ocean. 

It  is  hoped  that  this  book  will  instigate  further  research  con- 
cerning the  earliest  stages  of  human  existence. 

PROF.  DR.  LEOPOLD. 
Dresden,  Koenigliche    Frauenklinik,  January,  '07. 


TRANSLATOR'S  PREFACE. 


The  deplorable  fact  that  numerous  important  contributions  to 
medical  literature,"  appearing  in  the  German  language,  remain 
unread  by  the  English-speaking  fraternity  as  the  result  of  an  im- 
perfect acquaintance  with  that  tongue,  induced  me  to  undertake 
the  translation  of  this  valuable  study  of  one  of  the  youngest 
human  ova  found  in  situ.  When  requested  to  do  this  work  by 
my  esteemed  former  chief,  Prof.  Dr.  Leopold,  I  was  impressed 
with  the  necessity  of  preventing  the  English-speaking  profession 
from  remaining  unacquainted  with  a  work  of  such  high  order. 

This  book  should  prove  interesting  and  instructive  not  only 
to  the  embryologist  and  the  obstetrician,  but  also  to  the  profession 
in  general,  and  if  by  its  translation  I  shall  have  succeeded  in  dis- 
seminating a  clearer  knowledge  of  this  complex  subject,  I  shall 
feel  amply  repaid  for  my  labor. 

In  conclusion  I  wish  to  thank  my  friend  and  colleague, .  Dr. 
Hugo  Ehrenfest,  for  the  very  kind  and  valuable  assistance  which 
he  rendered  me  in  the  translation  of  the  book,  and  I  also  wish 
to  express  my  indebtedness  to  Mr.  Geo.  Heithaus,  stud.  med.. 
for  his  aid  in  the  reading  of  the  proofs. 

W.  H.  VOGT,  M.  D. 
St.  Louis,  Mo.,  September,  1907.    4977  Lotus  Ave. 


10 
CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM  FROM  SECTIONS  1-160. 


No.  of 
Section. 

Mucous  i 

Without 
fibrin  cover. 

nembrane  elevation  narbonn 

With 
fibrin  cover. 

y  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

I. 

— 

— 

— 

— 

3- 

— 

.      — 

— 

— 

4- 

— 

— 

— 

— 

like  i  and  3. 
6. 

— 

— 

The       mucous 
membrane 
protuberance 
which  later  be 
elevation,  enci 
um. 

comes  the  ovular 
rcled  by  epitheli- 

7- 

Mucous  membrane  becomes 
thicker. 

Epithelium 
varying  in 
thickness. 

— 

8. 

— 

— 

Epithelium 
varying  in 
thickness. 

— 

Q. 

— 

— 

The   well    pre- 
served    surfact 
which  a  large  g 
over  the  elevat 

;     epithelium     in 
land  opens  passes 
ion. 

IO. 

— 

Suddenly     a     thin    fibrin 
cover  appears  over  ele- 
vation   ("Gewebspilz" 
Peters'.) 

— 

Under  which  a 
trace   of     sur- 
face     epitheli- 
um   is    to    be 
.  seen. 

II. 

— 

Firbin  cover  increases  in 
thickness  toward  right. 

Over   fibrin 
cover   epithe- 
lium   varying 
in  thickness. 

Not  clear. 

12. 

— 

Present. 

— 

— 

11 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

In  the  small  elevation  on  the  surface  of 
the    mucous    membrane,    glands    and 
capillaries  plentiful;   glands  with  per- 
fect epithelium. 

— 

— 

i. 

Capillaries    already 
considerably    di- 
lated. 

Glands  as  in  i. 

— 

— 

3- 

Numerous  capillar- 
ies in  elevation  of 
mucous        mem- 
brane surface. 

Greatly    dilated 
glands  with  per- 
fectly   preserved 
epithelium. 

— 

Fig-  3- 

4- 

« 

•• 

— 

— 

like 
i  and  3. 
6. 

Blood     and     capil- 
laries present. 

No  glands  in  sum- 
mit of  ovular  ele- 
vation. Dilated 
gland  in  depth  of 
section. 

Here  the  first  suspicion  of 
Eianlage  by  presence  of 
syncytial  cells.  Accumula- 
tion of  leucocytes. 

— 

7- 

Dilated     capillaries 
in  elevation  and 
communicating  bl< 
ed  with  syncytial  c 

X)d  spaces  infiltrat- 
,ells. 

Scattered  syncytial  cells, 
accumulation  of  leuco- 
cytes. 

— 

8. 

Blood  spaces  in  ele- 
vation, whose  in- 
tervening    walls 
contain  fibrin. 

A  large  gland 
opens  into  eleva- 
tion on  the  same 
well  preserved 
surface  epitheli- 
um. 

Scattered  syncytial  cells. 
Tissue   of   elevation   some- 
what infiltrated  with  blood. 

— 

Q. 

In  the  mound  con- 
fluent          vessel 
spaces. 

— 

Infiltrated  with  trophoblast 
processes  with  a  layer  of 
syncytial  covering. 

Fig.  4. 

10. 

Capillaries    become 
dilated  in  eleva- 
tion. 

Glands    in    eleva- 
tion  and   sur- 
rounding,    num- 
erous and  plain- 
ly visible.  . 

The  inner  blood  space  in  the 
ovular  elevation  surround- 
ed with  syncytial  cells. 

— 

1  1. 

Blood  spaces  as  in 
1  1. 

— 

— 

— 

12. 

12 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM  FROM  SECTION   1-160. 


Mucous  membrane  elevation  harboring  the  ovum. 

No.  of 

Section. 

Without 
fibrin  cover. 

With 
•     fibrin  cover. 

Epithelium 
above. 

Epithelium 
beneath? 

14. 

— 

Present. 

— 

Band    of    epi- 

To the  left  and 

thelium     on 

under  the  fibrin 

the          fibrin 

covering      sur- 

15- 

— 

Present. 

cover     which 

face  epithelium. 

sinks  into  the  right      somewhat 

swollen  end  of  the  fibrin  cover 

like  the  mouth 

of  a  gland. 

Instead     of     as 

• 

above,  there  is 

1  6. 

— 

Present. 

found    only    a 

slight  funnel-like   depression   of 

tissue  cells  anc 

blood  cells. 

Still    somewhat 

'7- 

— 

Present. 

of  a  funnel-like  depression  of  tis- 

sue cells. 

Somewhat  of  a 

" 

depression  cov- 

1 8. 

— 

An     entirely  structureless 

— 

ered  with  epi- 

mass. 

thelial-like 

cells. 

To  the  left  un- 

der   the   fibrin 

cover,     epithe- 

iQ. 



'    " 

funnel-like  dep 

lium     present, 
ression  still  pres- 

ent.     In  it  or  rather  between  it 

and  the  fibrin  cover  many  blood 

cells. 

Under  the  fibrin 

Present. 

— 

cover    a    long 

epithelial     like 

band,       which 

At  certain  parts  aggrega- 

probably   originates    from     the 

20. 

— 

tion   of  leucocytes.     Oc- 

syncytial offshoots  which  closely 

casionally    large    syncy- 

approach    the  fibrin   cover   and 

tial  cells,  but  without  a 

may  easily  be  mistaken  for  uter- 

nucleus. 

ine  epithelium. 

13 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

— 

— 

Trophoblast   with   syncytial 
offshoots. 
Blood  present. 

— 

14. 

Decidual  cells  between  the  dilated  capil- 
laries and  glands. 

Processes  of  trophoblast  with 
offshoots. 

Fig-  5- 

15- 

— 

— 

— 

— 

1  6. 

— 

— 

At  the  periphery  of  the  ovu- 
lar  chamber,  syncytial  cells 
found. 

— 

>7- 

On    the   border   of 
the   various  cap- 
illaries   syncytial 
cells,  partly  aris- 
ing   from    endo- 
thelium. 

— 

— 

— 

18. 

Same. 

Numerous  elonga- 
ted    and     some 
greatly    dilated 
glands. 

Same. 

Fig.  6. 

19. 

— 

— 

Trophoblast  with  syncytial 
offshoots  pass  well  up  un- 
der the  fibrin  covering. 

— 

20. 

14 
CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION    1-160. 


No.  of 
Section. 


Mucous  membrane  elevation  harboring  the  ovum. 


Without 
fibrin  cover. 


With 
fibrin  cover. 


Epithelium 
above. 


Epithelium 
beneath? 


Present. 

Becoming  steadily  longer 
and  lies  like  a  worm  with 
its  thick  end  on  the  right 
of  the  ovular  elevation. 


Epithelium 
varying    in 
thickness    on 
the  fibrin  cov- 


An    epithelial- 
like  band  com- 
ing from   both 
sides  under  the 
fibrin  cover. 


Most  likely  syncytial  cells. 


23. 


24  and  25. 


In  elongated  part,  connec- 
tive tissue  arrangement. 
Leucocytes,  and  in  the 
club  end  fibrin  only.  Be- 
tween these  two  parts  as 
well  as  towards  the  ovu- 
lar elevation  many  red 
blood  cells. 


Epithelium  Under    the   fib- 

varying  in  rin  cover  long 

thickness    on        streaks  of  epi- 
the  fibrin  cov-        thelial-like 
er.  cells. 

Close  on  to  these  the  long 
stretched  syncytial  cells  with 
large  nuclei  reach,  which  come 
from  the  trophoblast. 


The  elongated  part  be- 
comes more  and  more  or- 
ganized, the  club  end  is 
still  fibrinous  but  is  al- 
ready infiltrated  with 
white  blood  cells. 


Epithelium 
varying  in 
thickness 
above. 


The  same. 


26. 


The  fibrin  cover  becomes  Epithelium 
constantly  longer  and  '  varying  in 
has  at  its  right  end  a  but-  thickness, 
ton-like  thickening  con- 
taining many  red  blood  cells.  The  left  end 
a  structureless  elongation.  Therefore  only 
the  middle  part  is  organized. 


As  in  23. 


27. 


Fibrin  cover  very  much 
elongated,  on  the  right 
end  knob-shaped,  folded 
like  a  corpus  luteum,  in 
the  center  of  fold,  blood 
cells.  The  left  end  sends 
out  an  offshoot  and  be- 
comes steadily  longer. 


Epithelium 
varying  in 
thickness 
fi  b  r  i  n 


An    epithelial- 
like   band   un- 
der fibrin  cov- 
er.    Under  the 
elongated    left 


o  n 
cover. 

end  of  the  fibrin  cover  this  band 
contains  a  few  cells  with  a  dis- 
tinct nucleus  and  under  the 
same,  running  parallel  with  it, 
are  seen  the  large  syncytial 
cells. 


28  and  29. 
same  as 
27- 

30. 


Fibrin  cover  as  in  27. 
Blood    found    in    fold    of 
knob  end. 

At  the  base  of  fibrin  cover  are  found  syncytial 
clubs  with  many  nuclei.  Close  by,  an  epithe- 
lial-like  band. 


Epithelial-like 
band     to     left 
under    fibrin    cover.     Probably 
having  some  connection  with  the 
giant  syncytial  cells. 


15 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

Vessels  dilate,  their 
walls     become 
thinner  and  rup- 
ture.     Blood  es- 
capes and  passes 
into    the    neigh- 
boring glands. 

— 

Eianlage,     with    projection, 
now  seen  cut  laterally. 

Fig-  7- 

22. 

Endothelium  of  the 
capillaries        en- 
larged.   Contains 
large  nuclei. 

Glands  to  the  side 
of  the  ovum  may 
be  seen  almost  in 
their            entire 
length.      Various 
others  filled  with 
blood. 

Eianlage  has  a  projection 
with  a  broad  end.  Ovular 
chamber  filled  with  blood. 

— 

23. 

" 

" 

Eianlage  with  trophoblast 
buds  and  projections  which 
anchor  themselves  in  the 
periphery  of  the  ovular 
chamber.  Projections  with 
trophoblast  nuclei  and  syn- 
cytial  covering. 

— 

24  and  25. 

At  the  broad  base 
the   blood   vessels 
become  more  con- 
fluent and  take  up 
the    protruding 
trophoblast  proc- 
esses. 

To    the    left    and 
right  of  ovum  ex- 
cellently    pre- 
served, some  bro- 
ken    open      and 
filled  with  blood. 

Eianlage,  larger  and  takes  on 
a  more  definite  form. 

— 

26. 

Toward  the  ovular 
chamber  the  con- 
fluent  blood    ves- 
sels are  now  divid- 
ed by  an  arch-like 
arrangement       of 
fibrin. 

» 

Eianlage  as  in  26,  passing 
from  it  to  the  fibrin  cover 
are  five  trophoblast  proces- 
ses with  offshoots  of  syncy- 
tium.  In  the  surrounding 
of  the  Eianlage  decidual 
cells. 

Fig.  8. 

27. 

Passing  from  the  Ei 
blast  processes  and  s 
free  blood,  likewise  i 

anlage  to  the  knob  e 
yncytial  offshoots  are 
n  the  fold  of  the  fibr 

Eianlage  manifold,  elongat- 
ed    and     somewhat    com- 
pressed    by     free     blood, 
nd  of  the  fibrin  cover,  tropho- 
seen.     Between  the  offshoots 
n  cover. 

Section 
26-28. 
Fig.  Q  and 
Fig.  10. 
Section 

3°- 
Fig.  n. 

28  and  29 
same  as 

27. 

30. 

16 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160. 


No.  of 

Mucous  membrane  elevation  harboring  the  ovum. 

Section. 

Without 
fibrin  cover. 

With 
fibrin  cover. 

1 

Epithelium 
above. 

Epithelium 
beneath? 

Between  fibrin  cover  and 

3>- 

— 

periphery  of   the  ovular 
chamber,  many  processes 
of  syncytium  with  many 

— 

— 

nuclei. 

32. 

—       • 

Between  fibrin  cover  and 
neighboring  border  many 
syncytial  giant  cells. 

Band  of  epithe- 
lium not  dis- 
tinct. 

To  the  right  un- 
der   the   fibrin 
cover,  presum- 
ably    a     rem- 
nant    of     epi- 
thelium. 

33- 

— 

Present. 

Below  and  above  fibrin  cover  no 
band  of  epithelium  left. 

34- 

— 

Giant  syncytial  cells  reach 
to  fibrin  cover. 

— 

Absent. 

Only     toward 
and  under  fib- 

35- 

Present. 

rin  cover  are  4 
epithelial-like 
formations. 

36. 

— 

Present. 

Elongated    with    club- 
shaped  end. 

— 

Is  similated  by 
rows  of  epithe- 
lial-like syncy- 
tial cells. 

Present. 

Under  the  knob 

37- 

—  . 

Elongated  with  knob  end, 
which     appears     like     a 
thick  fibrin  band. 

Band  of  vary- 
ing thickness. 

end   an  epithe- 
lial-like   band 
surrounded  by 
blood  cells. 

The  elongated  part  of  the 
fibrin  cover  here  resem- 

38. 

— 

bles  some  of  the  previous 
specimens.       The  knob- 
like  end  is  more  fibrinous 

— 

— 

but  is  already  beginning 
to     be    infiltrated    with 

, 

leucocytes. 

17 


CONSIDERATION  OF  THE   RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

— 

— 

Tropholbast  processes.   Coat 
elevated  by  blood  and  con- 
sists of  two  layers.     Row  of 
nuclei  with  syncytial  cov- 
ering. 

— 

31- 

— 

— 

Trophoblast   processes   with 
offshoots  pass  toward  per- 
iphery,  where  fibrin  cover 
lies.     Coat  elevated,  2  lay- 
ers:  Langhans'     cells     and 
syncytial  covering. 

Fig.  12. 

32. 

— 

— 

Eianlage  with  partly  elevat- 
ed coat. 

— 

33- 

— 

— 

— 

— 

34- 

Blood    vessels    dis- 
integrating. 

— 

Processes  of  trophoblast. 

— 

35- 

— 

— 

Mesoblast    and    Ectoblast 
(Trophoblast  and  Syncytial 
cells)  pass  under  entire  fib- 
rin cover  along  the  wall  of 
the  ovular  envelope. 

— 

36. 

Owing    to    the    in- 
creasing size  of  the 
ovum     the    sur 
rounding        blood 
vessels     become 
more     and     more 
disintegrated, 
to  the  ovum  but  doe 
ovular  chamber. 

To  the  right  and 
left  of  ovum  two 
glands.       In  the 
middle    of    these 
a    third    gland 
which  gradually 
dilates  and  passes 
s  not  open  into  the 

— 

Fig.  14. 

37- 

•       — 

The  same. 

The  syncytial  cells  pass  up 
to  the  ovum  periphery  and 
make  the  impression  of  sur- 
face epithelium. 

— 

38. 

18 
CONSIDERATION    OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


No.  of 
Section. 

Mu 

Without 
fibrin  cover. 

:ous  membrane  elevation  har 

With 
fibrin  cover. 

boring  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

39- 

the  one  side  of  wh 
arising  from  the  t 

Present. 
Under  the  long    offshoots 
of    the    fibrin     cover     a 
long  blood  vessel  present, 
ich  consists  of  broad  cells 
'ophoblast. 

Over  the  knob 
end   a  worm- 
like  cover. 

—  • 

40. 

i 

— 

The  elongated  part  of  the 
fibrin  cover  is  made  up 
of  distinct  tissue.      The 
knob  end  is  arranged  ex- 
actly like  a  corpus  lute- 
um. 

Over  the  knob 
end    a    band 
varying        in 
thickness. 

Under  the  knob 
end      reaching 
from   the   bor- 
der, an  epithe- 
lial band. 

41  like 
40. 

— 

Same. 

Under    the    entire    fibrin 
cover,  large  svncy  tial  cells 
are  seen. 

— 

— 

42. 

— 

Under  the  knob  end  syn- 
cytial  giant  cells. 

— 

— 

43- 

— 

The  knob  end  of  the  fibrin 
cover  is  infiltrated  with 
leucocytes. 

— 

— 

45- 

— 

Under  the  fibrin  cover  the 
row    of    syncytial    cells 
have    become    consider- 
ably larger. 

— 

— 

47- 

'— 

Present. 

— 

— 

49- 

— 

Present. 

gated     syncyti 
might   be   mist 
epithelium. 

Under    the   fib- 
rin cover  elon- 
al     cells,     which 
aken   for  surface 

5«- 

— 

The   knob   end   becoming 
shorter  and  rounder. 

— 

Elongated    syn- 
cytial cells  be- 
low. 

19 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160 


Blood 
vessel. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

— 

Left    gland    with 
broad  opening. 
Right  gland  surro 
die  one  which  reac 
with  blood. 

unds  entire  ovum.     The  mid- 
hes  to  the  ovum  becomes  filled 

Fig.  13. 

39- 

— 

— 

From  the  trophoblast  an  ex- 
tension   of    syncytial    cells 
pass   to   the   epithelial-like 
band  on  the  border  under 
the  knob  end. 

— 

40. 

— 

— 

As  in  40. 

— 

41  like 
40. 

— 

— 

Covering  with  syncytial  buds. 

— 

42. 

— 

— 

— 

— 

43- 

of  the  ovum  can  be 
the  entire  length  tc 

The  two  glands  to 
the  right  and  left 
followed  almost  in 
their  openings. 

Covering  has  two  rows. 

— 

45- 

A  broad  part  of  the 
contact  a  double  ce 
visible.     Here  as  in 
which  anchor  them; 

ovum  lies  under  the 
1  row  (Langhans*  eel 
48  one'  sees  large  of 
elves  into  the  peripri 

Processes  of  trophoblast  with 
offshoots, 
fibrin  cover.     At  the  point  of 
,s  and  Syncytium)  are  plainly 
"shoots,  from  the  trophoblast, 
ery  of  the  ovum. 

Fig.  1  6. 

47- 

— 

— 

Offshoots    with    covering 
which    become    anchored. 
(Section  50.) 

— 

49- 

In  the  periphery  of 
the  ovum  toward 
the  middle  of  the 
mucosa   uteri,    an 
enormously   dilat- 
ed vessel. 

— 

Eianlage   with    offshoots    as 
heretofore. 

— 

5'- 

20 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160 


No.  of 
Section. 

Mu 

Without 
fibrin  cover. 

cous  membrane  elevation  hai 

With 
fibrin  cover. 

boring  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

52. 

— 

Under  fibrin  cover  enor- 
mous syncytial  cells. 

— 

— 

53- 

— 

The  fibrin  cover  becomes 
more  compressed.       (Al- 
most structureless.) 
Giant  syncytial  cells  be- 
low. 

— 

— 

54- 

— 

The  knob  end  rounder  and 
thicker,  under  the  same 
thick  syncytial  cells,  with 
many  nuclei. 

— 

— 

55  and  56. 

— 

Under  the  fibrin  cover  the 
syncytial  cells  constant- 
ly increasing  in  number. 

— 

— 

57- 

— 

Under  entire  length  of  fib- 
rin cover  larger  and 
smaller  syncytial  cells  are 
found. 

Over  knob  end 
of  fibrin  cov- 
er a  band  of 
epithelium 
varying        in 
thickness. 

— 

58  and  59. 

— 

Fibrin  cover  compressed, 
shortened  and  thickened. 
Beneath  syncytium. 

— 

— 

60. 

structureless  knob 
has  become  organi 
syncytial  cells  are 

The  fibrin  cover  now  pre- 
sents itself  as  an  almost 
the  rest  of  the  fibrin  cover 
zed.      Under  this  cover  the 
constantly  multiplying. 

— 

— 

6  1  and  62. 

— 

Among  these  syncytial 
cells  trophoblast  cells  are 
observed. 

— 

— 

63. 

— 

The  knob  end  like  a  but- 
ton. Under  the  same 
rows  of  syncytium,  which 
pass  almost  to  the  outer 
border  of  the  covering. 

— 

— 

f   21 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


Blood 
vessels. 

Glands. 

Einlage. 

Illus- 
tration. 

No.  of 
Section. 

— 

— 

Band  of  ectoblast  with  Lang- 
hans'  cells  and  syncytium. 
In   Eianlage  peculiarly  ar- 
ranged cells. 
Embryonic  rudiment? 

Fig.  26. 

52. 

— 

— 

Eianlage  lies  plainly  on  the 
periphery  with  a  covering 
of  two  layers. 

— 

53- 

The  enormously  di- 
lated   blood    ves- 
sels as  in  51. 

— 

Trophoblast  processes  with 
syncytium  anchored  to  per- 
iphery of  ovum. 

— 

54- 

• 

— 

— 

55  and  56. 

Dilated   capillaries. 

well   preserved   unc 
due  to  the  confluen 
Enormously   dilated 
present  in  51. 

Beautifully    ar- 
ranged,      partly 
ergoing  dissolution 
t  blood  vessels, 
blood   vessels   still 

The  albuminous  mass  in  the 
Eianlage  compressed  by 
blood  in  the  ovular  cham- 
ber. 

— 

57- 

— 

To    the    left    and 
right    of    ovum, 
glands  with  open- 
ings. 

Eianlage  with  trophoblast 
processes  and  syncytial  off- 
shoots. 

— 

58  and  59. 

The  enormously  di- 
lated   blood    ves- 
sels   divided    into 
three     spaces     by 
the    decidual    tis- 
sue. 

— 

Eianlage  with  trophoblast 
processes.  Syncytial  cov- 
ering. 

Fig.  17. 
Fig.  27. 

60. 

— 

The  two  glands  to 
the  left  and  right 
are         distinctly 
visible. 

Eianlage,  as  in  60. 

— 

6  1  and  62. 

— 

The  same. 

Eianlage  with  trophoblast 
and  offshoots. 

Fig.  1  8. 

63. 

22 
CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


No.  of 
Section. 

Mu 

Without 
fibrin  cover. 

cous  membrane  elevation  hai 

With 
fibrin  cover. 

boring  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

65  and  66. 

— 

The  knob-like  end  becomes 
flatter. 

— 

— 

67  and  68. 

— 

The    knob    becomes    still 
flatter  and  is  hardly  vis- 
ible in  68..     Beneath  it  a 
layer  of  syncytium. 

— 

— 

69. 

— 

The    knob    but    a    small 
structureless        fibrinous 
elevation.     Layer  of  syn- 
cytium beneath  it. 

— 

— 

70-73. 

— 

The   knob    is  as  69.     Be- 
neath  it  syncytium, 
which  might  be  mistaken 
for    uterine    surface 
epithelium. 

In  73  a  layer  of 
epithelium 
varying        in 
thickness. 

—  * 

74- 

— 

The  knob  as  in  73. 

As  in  73. 

— 

75- 

becomes  longer  an 
cover. 

The  fibrinous  structureless 
mass,    which    has    been 
but   a   tiny   knob,   again 
d  lies  on  the  organized  fibrin 

— 

— 

76-79. 

— 

The  fibrinous  structureless 
mass     becomes    steadily 
longer.        Syncytium   is 
seen  beneath  this  mass. 

A  band  of  epi- 
thelium vary- 
ing  in    thick- 
ness. 

Similates     uter- 
ine surface  epi- 
thelium. 

80. 

— 

The  structureless  mass  be- 
comes steadily  longer  and 
begins  to  appear  as  be- 
fore. 
(See  sections  10-25.) 

An    epithelial- 
like  band. 

— 

Si. 

— 

— 

— 

— 

82  and  83. 

— 

— 

— 

— 

84. 

— 

Fibrin  cover  with  a  band  lying  above  it. 

A  few  cells  be- 
neath.      (Epi- 
thelial cells?) 

23 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION  1-160- 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

— 

— 

— 

— 

65  and  66. 

— 

Glands  plainly  vis- 
ible to  the  right 
and  left. 

Eianlage  toward  the  sum- 
mit with  trophoblast. 

— 

67  and  68. 

— 

Glands  plainly  vis- 
ible  to   the  left; 
to  the  right  they 
are  displaced. 

Eianlage  with  beautiful  tro- 
pholbast  processes  and  off- 
shoots with  syncytium. 

Fig.  IQ. 

69. 

— 

The  same. 

The  same. 

— 

70-73. 

— 

— 

Numerous  syncytial  cells 
scattered  in  the  surround- 
ing of  the  ovum. 

— 

74- 

— 

The  same. 

Eianlage  with  trophoblast 
processes. 

Fig.  20. 

75- 

— 

— 

—       ' 

— 

76-79. 

— 

The  same. 

The  same. 

Fig.  21. 

80. 

— 

— 

Polymorphous    and    pressed 
together   by    Eianlage   and 
ectoblast.      The   latter  ar- 
ranged  like   numerous 
prongs.    Trophoblast  proc- 
esses. 

(View 
of 

entire 
ovum.) 

81. 

— 

— 

Large  trophoblast  processes 
with  syncytial  offshoots 
extending  to  the  border 
and  walls  of  the  blood  ves- 
sels. 

— 

82  and  83. 

— 

— 

Trophoblast  processes  with 
syncytium  plainly  visible, 
In  the  periphery  of  the  ovu- 
lar  chamber  large  syncy- 
tial cells. 

— 

84. 

24 
CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM  FROM  SECTION   1-160. 


Section. 

Without 
fibrin  cover. 

With 
fibrin  cover. 

Epithelium 
above. 

Epithelium, 
beneath? 

85. 

— 

— 

— 

— 

Under    fibrin 

cover   a   chain 

86 
and 
87. 

— 

The  fibrin  cover  becomes 
longer  and   on   its   right 
end    has    a   knob   -   like 
thickening. 

Epithelium 
spreading 
above  it. 

.of    cells    (Epi- 
thelium?)     At 
the  right   bor- 
der a  distorted 
gland.      Blood 
has        entered 

it. 

88. 

band  a  fine  layer  ol 
ed  syncytial  cells  c 

Fibrin  cover  larger. 
Toward     the     epithelial 
fibrin  is  seen;-  then  elongat- 
ccasionally  trophoblast. 

A    long    band 
of  epithelium 
over  it. 

Under  it  a  torn 
epithelial  band 
however         in 
better  pres- 

ervation. 

Under    the   fib- 

rin   cover,    os- 

89. 

Present. 

tensibly  an  ep- 
ithelial layer. 

Present? 

90-92. 

— 

Elongated. 

Present. 

Immediately 
below     it     are 

biids  of  syncy- 

tium. 

93- 

— 

Larger. 

4 

Epithelium    above    and    beneath 
the  fibrin  cover. 

94. 

— 

Distinct. 

— 

— 

95  and  96. 

— 

The  same. 

Present. 

Present. 

CONSIDERATION  OF  THE   RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION    1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration.' 

No.  of 
Section. 

To    the    right    be- 
tween   the   ovular 
chamber   and    the 
adjoining     glands 
new    capillaries 
are  constantly  be- 
ing opened. 

The  large  gland  to 
the    left    of    the 
ovum  reaches  to 
the  border.     The 
almost  in  its  enti 
becomes     lost     th 
periphery. 

inland  to  the  right  can  be  seen 
re  length.     The  middle  gland 
e    nearer   it    approaches    the 

— 

85. 

Confluent    capillar- 
ies  at   the  border 
becoming    dis- 
solved. 

Also  from  the  endott 
near  the  border  ol 
cells   are  seen   prol 
syncytial  cells. 

Long     glands     to 
the  right  and  left. 
The   middle   one 
does     not     quite 
extend      to     the 
ovum. 

elium  of  the  vessels 
the  ovum  cavity, 
ferating,   similating 

— 

— 

86  and  87. 

— 

— 

The  offshoots  of  a  long  tro- 
phoblast  plug  radiates 
toward  a  vessel. 

— 

88. 

— 

etrates   an    adjoin 
wall  has  been  pen 
its  neighbor.     Lar 
at  other  places. 

The  syncytium  passes  from 
a  trophoblast  plug  and  pen- 
ing   vessel.     After   the   vessel 
etrated  it  communicates  with 
ge  clusters  of  syncytial  cells 

— 

89. 

— 

The   three   glands 
as  in  86  and  87. 

border.     The  sync 
group  of  vessels  in 
corroded  by  two  s 

Long   trophoblast   processes 
with  syncytium  at  the  ends. 
Becomes    anchored   at    the 
vtium  corrodes   a  vessel.     A 
the  border  are  likewise  being 
yncytial  offshoots. 

Fig.  28. 

90-92. 

Vessels   in   dissolu- 
tion in  the  border. 

The  glands  to  the 
right  are  seen  in 
their    entire 
length.         Like- 
wise the  left.  The 
middle    glands 
disappear. 

Long   trophoblast   processes 
anchor   with    syncytium. 

Fig.  22. 

93. 

— 

The  middle  gland 
becomes  lost 
toward    the   bor- 
der of  the  ovum. 

Mesodern  distinct  and  poly- 
morphous.     At  the  border 
large  trophoblast  plugs  with 
syncytial  covering  become 
anchored  to  the  ovum  per- 
iphery. 

94- 

— 

The  middle  gland 
at  the  border  of 
the    ovum    with 
large   epithelial 
cells. 

Trophoblast  at  the  border  of 
the  ovum  (near  the  fibrin 
cover)    has    two    hook-like 
plugs  between  which  is 
found  considerable  blood. 

Fig.  23. 

95  and  96. 

26 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


No.  of 

Mucous  membrane  elevation  harboring  the  ovum. 

Section. 

Without 
fibrin  cover. 

With 
fibrin  cover. 

Epithelium 
above. 

Epithelium 
beneath? 

97  and  98. 



Fibrin  cover  has  sunk  into 
the  underlying  tissue. 

Bands   of   epi- 
thelium vary- 
ing  in    thick- 

Bands   of    epi- 
thelium. 

ness. 

99. 

— 

Fibrin  cover  elongated. 

Likewise. 

Bands    of    epi- 
thelium   vary- 
ing   in     thick- 

ness. 

100. 

— 

Present. 

Fibrin  strip  has 
a  layer  of  epi- 
thelium. 

Likewise 
below. 

IOI. 

— 

Fibrin     cover     depressed. 
To  the  left  epithelium. 

— 

Epithelium   (?). 
beneath    the 
fibrin  strip. 

Under    the    fib- 

1 02. 

~ 

Small  fibrinous  elevation. 

rinous  eleva- 
tion,  strips  of 
epithelium  (?) 

103. 

Fibrin    cover    en- 
tirely absent. 

Only  a  tiny  particle  there- 
of present. 

— 

Short  bands, 
(Surface  epi- 
thelium?) 

104 
and 
105. 

Absence  of  fibrin 
cover. 

— 

— 

— 

1  06 
and 
107. 

The  same. 

•   — 

Surface  epithe- 
lium   fairly 
well    pre- 
served. 

— 

1  08. 

The  same. 

— 

I  10 

and 

The  same. 

— 

—      • 

— 

in. 

27. 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM    SECTION   1-160 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

cells  close  to  the  ov 
lost  however  the  cl 
the  ovum.      To  th« 
the  left  i  to  2  glanc 

Middle  gland   has 
large        epithelial 
um,  which  become 
aser  they  approach 
:  right  2  glands,  to 
s. 

Trophoblast  processes  with 
syncytium. 

— 

97  and  98. 

— 

Three  glands. 

Trophoblast  processes  with 
syncytium. 

— 

99. 

— 

Three  glands. 
The    middle   one 
begins    to   disap- 
pear. 

Trophoblast  processes.  Syn- 
cytium reaches  to  the  bor- 
der. 

— 

100. 

— 

Three  glands. 

Beautiful  tropholbast  proc- 
esses. 

— 

101. 

— 

The  middle  gland 
is     seen     plainly 
reaching    to    the 
ovum. 

Trophoblast  processes  reach 
almost  to  the  border  of  the 
ovum.  Syncytial  buds 
reach  to  the  under  border  of 
fibrinous  elevation. 

— 

1  02. 

— 

The  middle  glands 
not     so     plainly 
visible. 

The     trophoblast     and     syn- 
cytium reach  to  the  band 
beneath    the   beginning   of 
the  fibrin  cover. 

— 

103. 

— 

The  middle  gland 
reaches  almost  to 
the  ovum. 

— 

Fig.  24. 

104 
and 
105. 

— 

Two    new    glands 
are  seen   on    the 
border  of  a  dilat- 
ed vessel. 

Trophoblast  processes  with 
syncytium  and  giant  cells. 

— 

106 
and 
107. 

seen.      In  later  sec 
comes  more  plainly 
length. 

The  end  of  a  large 
gland    is    plainly 
tions  this  gland  be- 
visible  in  its  entire 

Trophoblast  processes. 

— 

1  08. 

Capillary  spaces. 

The     gland     very 
distinct,           the 
opening  however 
has    become   less 
distinct.      Other 
glands  with  their 
epithelium    have 
become  destroyec 
through     hemor- 
rhage. 

Buds  of  syncytium. 

— 

I  10 

and 
in. 

28 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION    1-160. 


No.  of 
Section. 

M 

Without 
fibrin  cover. 

ucous  membrane  elevation  ha 

With 
fibrin  cover. 

rboring  the  ovum 

Epithelium 
above. 

Epithelium 
beneath? 

I  12. 

Not  a  suspicion  ol 
a  fibrin  cover. 

— 

— 

— 

113. 

The  same. 

— 

— 

i  14-1  i  6. 
1  17  and  1  1  8. 

The  same. 

— 

— 

— 

IIQ. 

— 

A  trace  of  fibrin  present. 

— 

— 

121 

and 

122. 

Not  a  trace  of  fib- 
rin     except     on 
ovular  elevation. 

— 

— 

— 

123. 

and 
124. 

The  same. 

— 

— 

— 

125-128. 

— 

— 

— 

— 

129-131. 

— 

— 

— 

— 

132. 

— 

— 

— 

— 

133. 

— 

— 

— 

— 

29 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


Blood 

vessel. 

Glands. 

Eianlage. 

Illus- 

No. of 

tration. 

Section. 

|  The  mouth  of  the 
gland  disappears. 

In  a  gland  filled  with  blood,  the  epithe- 
lium cells  are  swollen,  partly  enlarged 
and  elevated  from  base. 


Buds  of  syncytium. 


A  gland  at  the  bor- 
der. Close  to  the 
pole  of  the  ovum,  a  gland  lined  with  epi- 
thelium and  greatly  dilated,  is  seen 
filled  with  blood. 


113. 


Dilated  capillaries 
surround  the  ov- 
um. 


A  large  long  gland 
close  to  the  ovum 


Syncytium  anchor. 


i 14-1 16 
117 
and  1 1 8. 


The  mouths  of 
two  glands  on 
top  of  the  ovum. 


Delicate    processes   'become 
anchored  to  the  periphery. 


119. 


Cavernous  Wood 
spaces  in  the  per- 
iphery of  the  ov- 
um. 


A  gland  opening. 


Between  the  cavernous  blood 
spaces  the  syncytium  is  ar- 
ranged in  arches. 


121 
and 
122. 


Cavernous  blood 
spaces  surround- 
ing the  ovum. 


Many    capillaries 
open    in    the   sur- 
rounding   of     the 
central   blood 
space. 


Two   gland   open- 
ings close  to  top 
of   the   ovum 
mound. 


123 
and 
124. 


To  the  right  of  the 
ovum  a  gland 
with  a  distinct 


opening 

alone; 

capillary. 


passes 
a    dilated 


The  interior  of  the  ovum 
filled  with  blood,  this  is 
enclosed  by  arch-like  ar- 
ranged syncytial  cells. 


125-128. 


A  number  of  capil-  Glands  as  in  132. 
laries  open  at  a 
place  which  was 
previously  occupied  by  the  nucleus  of 
the  Eianlage  and  break  into  discern- 
ible glands. 


Syncytial  cells  become  less. 


In  the  periphery  Still  more  syncytial  cells 
of  the  ovular  ele-  with  large  well  stained  nu- 
vation  four  clei. 

glands  are  plainly  visible  partly  a.)  dissolved  in  capillaries,  at  their 
opening  or  in  the  center,  b.)  fairly  well  traceable  in  their  entire  length, 
c.)  not  plainly  visible,  d.)  opening  not  distinct,  toward  the  interior 
dilation  plainly  visible. 


132. 


Capillaries  break 
into  glands. 


Syncytial    cells    with    large 
nuclei. 


'33- 


30 


CONSIDERATION    OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION    1-160. 


No.  of 
Section. 

Mu 

Without 
fibrin  cover. 

cous  membrane  elevation  hai 

With 
fibrin  cover. 

boring  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

134-136. 

— 

— 

— 

— 

137-I39- 

— 

— 

— 

— 

140. 

— 

— 

— 

— 

141. 

— 

— 

— 

— 

142 
and 
143. 

The  mucous  membrane  elevation  upon  which 
no  fibrin  cover  is  present,  shows  a  few  conflu- 
ent blood  spaces  in  the  center,   besides   this 
beautiful    glands    and    numerous    blood    ves- 
sels. 

— 

— 

144 
and 
145. 

— 

— 

— 

— 

147. 

— 

— 

Rests  of     sur- 
face   epithe- 
lium. 

— 

151. 

Divided  blood  spaces  in  the  ovular  elevation. 

— 

— 

152. 

— 

— 

— 

— 

'51 
and 

•55- 

— 

— 

Surface  epithe- 
lium   present 
over      ovular 
elevation. 

— 

,  31 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. 

No.  of 
Section. 

Syncytial   cells   be- 
tween   the    blood 
spaces. 

— 

Syncytial  cells  not  so  num- 
erous. 

— 

134-136. 

The     vessels   pene- 
trate   the   glands. 

— 

— 

— 

i  37-'  39- 

The  endothelium  of 
the  vessels  contain 
large  nuclei,  parall 
lie  directly  on  the  v 

;1  with  these  a  few 
essels. 

— 

— 

140. 

Numerous  syncytial 
cells    in    the    sur- 
rounding   of    the- 
capillaries. 

— 

— 

— 

141. 

Greatly  dilated. 

Four  large  glands 
pass  through  the 
ovular    elevation 
but    much    more 
distinctly  visible  tl 
b.)  elongated;   c.  2 

In  the  center  of  the  mound 
many   syncytial   cells    and 
accumulation  of  leucocytes. 

lan  in  132.     a.)  greatly  coiled; 
nd  d.)  with  distinct  openings. 

Fig.  25. 

142 
and 
143. 

Confluent        blood 
spaces  in  the  cen- 
ter of  ovular  ele- 
vation. 

Gland   spaces  and 
mouths. 

A  few  syncytial  cells  and  ac- 
cumulation of  leucocytes  in 
the  surrounding  of  the  cen- 
tral blood  spaces.' 

— 

144 
and 
145. 

Dilated   confluent 
blood  capillaries  in 
the  ovular  eleva- 
tion. 

Glands        dilated. 
Between     them 
accumulation    of 
leucocytes. 

— 

— 

147. 

Capillaries    greatly 
dilated. 

In  the  surrounding  ol 
al  cells  are  present. 

Likewise            the 
glands. 

both  many  decidu- 

— 

— 

151. 

A    few    very    large 
syncytial          cells 
with  highly  stained 
in    the   more   centr 
spaces. 

nuclei  are  still  found 
ally    located    blood 

— 

— 

152. 

Central     blood 
spaces    and    with 
these  communicat- 
ing capillaries. 

— 

— 

— 

I51 
and 

155- 

32 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


No.  of 
Section. 

Mu 

Without 
fibrin  cover. 

cous  membrane  elevation  har 

With 
fibrin  cover. 

soring  the  ovum. 

Epithelium 
above. 

Epithelium 
beneath? 

156. 

Fibrin   with   large 
ovular  elevation. 

nuclei  passing   through  the 

— 

— 

,58. 

In  the  ovular  elevaiton  only  the  borders  of  the 
more  centrally  located  blood  spaces  can  be 
seen. 

— 

— 

1  60. 

Ovular  elevation  supplied  with  enormous  capil- 
laries. 

Uterine       sur- 
face   epitheli- 
um  present. 

— 

33 


CONSIDERATION  OF  THE  RECONSTRUCTION  OF  THE  OVUM   FROM  SECTION   1-160. 


Blood 
vessels. 

Glands. 

Eianlage. 

Illus- 
tration. • 

No.  of 
Section. 

To    the    left    and 

157:     Centrally 
large  blood  spaces. 

right      glandular 
spaces   partly 
filled  with  blood. 

156. 

— 

— 

— 

,58. 

Detached         capil- 
laries. 

Numerous  glands. 

— 

— 

1  60. 

GENERAL  CONSIDERATION  OF  THE  RECONSTRUCTION 
OF  THE  OVUM  FROM  SECTIONS  1  TO   160. 

It  may  here  be  stated  that  all  the  microscopic  sections  have  been 
embedded  with  the  summit  of  the  elevation  produced  by  the  ovum, 
pointing  to  the  right,  as  in  Fig.  2 ;  thus  the  entrance  into  the  fur- 
row formed  by  the  mucous  membrane,  also  opens  to  the  right. 
In  this  manner  the  meaning  of  the  constantly  recurring  terms 
"right"  and  "left"  in  the  description  of  the  sections,  is  obvious. 

I. 

THE  MUCOUS  MEMBRANE  ELEVATION  WHICH  HAR- 
BORS THE  OVUM,  AND  THE  DECIDUA  VERA. 

The  mucosa,  which  lines  the  corpus  uteri,  is  about  5  mm.  thick 
in  the  fundus  and  anterior  wall  but  about  8  mm.  thick  in  the 
middle  of  the  posterior  wall.  As  previously  mentioned,  numerous 
deep  and  irregular  furrows  divide  the  mucous  membrane  into  a 
number  of  fields.  Toward  the  internal  os  (Plate  I  Fig.  1.  o.  i.) 
the  mucosa  suddenly  becomes  thinner  and  assumes  the  charac- 
teristic appearance  of  the  plicae  palmatae.  It  is  here  only  2  to 
4  mm.  thick.  Since,  as  is  well  known,  the  mucous  membrane  of 
the  uterus  has  no  submucosa,  a  sharp  line  divides  it  from  the  un- 
derlying muscularis  (Fig.  2,  g.).  Any  thin  section  passing 
through  both  mucosa  and  muscularis,  if  held  to  the  light,  will 
distinctly  show  this  sharp  division  both  in  the  pregnant  and  the 
non-pregnant  uterus.  Nevertheless  the  connection  between  the 
mucosa  and  the  underlying  muscularis  is  a  very  firm  one.  The 
blind  ends  of  the  uterine  glands  are  fastened  by  means  of  a  very 
fine  meshed  connective  tissue  near  the  funnel  shaped  cavities 
and  holes  formed  by  the  muscular  fibres  which  are  visible  imme- 
diately below  the  mucosa,  both  in  transverse  and  oblique  sec- 
tions. 

In  Fig.  1  the  somewhat  lighter  spot,  marked  "Ovum,"  indi- 
cates the  seat  of  implantation  of  the  small  ovum.  It  lies  in  a 
slightly  protruding  elevation  of  the  mucosa  ("Schleimhauthue- 
gel")  nearer  its  slope,  which  gradually  loses  itself  in  a  broad  and 
rather  deep  furrow,  (vide  Fig.  2,  a — 2.  c.  Fig.  23,  sections 
94  to  96.) 

In  about  the  first  ten  sections  this  little  hill  appears  as  a  hori- 
zontal fold  of  the  mucosa  with  a  sharp  edge  (Fig.  2.  a.  h.) 
which,  as  can  be  seen  under  the  microscope,  begins  with  a  blunt 
34 


THE  MUCOUS    MEMBRANE    ELEVATION.  35 

extremity  and  has  a  gland  passing  through  its  entire  length. 
This  gland  in  its  middle  portion  is  dilated  and  folded  and  lined 
in  its  entirety  with  perfectly  preserved  cuboidal  epithelium. 

Gradually  this  hill  like  elevation  becomes  more  rounded  (Fig. 
2.  b.  h.)  with  a  sharp  groove  on  its  right  side.  This  shape  is 
maintained  through  almost  all  of  the  sections  until  section  160 
is  reached,  where  it  takes  on  a  more  club  shaped  appearance. 
The  furrow  to  its  right  has  become  somewhat  shallower  and  now 
runs  perpendicular. 

We  might  be  led  to  believe  that  this  elevation  was  brought 
about  by  the  embedding  of  the  ovum,  but  the  further  examination 
of  the  specimen  will  show  that  the  mound  is  only  the  marginal 
elevation  of  a  mucous  membrane  field,  lying  just  above  a  groove, 
through  which  the  ovum  has  bored  its  way. 

This  ovum,  like  the  ovule  of  Peters,  in  all  probability  has  en- 
tirely sunk  into  the  mucous  membrane,  so  that  we  also  find  in 
this  case  the  ovular  chamber  completely  surrounded  by  a  de- 
cidua  vera  which  extends  up  into  the  cap  which  covers  the  top 
of  the  ovum  and  protrudes  into  the  uterine  cavity.  Besides  this 
decidual  tissue  the  cap  contains  the  fibrinous  cover  consisting 
of  two  layers  or  two  flat  portions,  while  in  Peters'  case  the  clos- 
ure of  the  small  opening  on  the  top  is  formed  by  the  fibrin  lid 
alone,  in  this  case  the  nidus  of  the  ovum  represents  a  com- 
pletely closed  cavity  which  on  its  top  carries  the  fibrinous  cover. 

In  investigating  the  histologic  structure  of  this  mucous  mem- 
brane elevation  our  attention  is  at  once  drawn  to  the  decidual 
tissue,  the  glands  and  the  blood  vessels,  the  ovular  chamber  and 
its  fibrin  cover.  Since  the  two  last  named  structures  will  be  con- 
sidered in  the  next  chapter,  the  enveloping  tissue  alone  shall  here 
be  described. 

It  is  probably  unnecessary  to  state  that  the  younger  the  ovum, 
the  better  will  be  the  opportunity  of  studying  the  origin  of  cer- 
tain structures  such  as  the  decidual  cells,  the  syncytium,  the  inter- 
villous  spaces,  etc. 

If  any  doubt  has  still  existed  concerning  the  fact  that  the  de- 
cidual cells  are  nothing  else  but  hypertrophied  connective  tissue 
cells  of  the  uterine  muscosa  and  have  nothing  to  do  with  the 
leucocytes,  this  doubt  is  now  dispelled  by  this  specimen. 

The  mucous  membrane  enveloping  the  ovum  is  swollen  and 
appears  edematous.  Large  connective  tissue  cells  with  long  pro- 
cesses form  a  delicate  network.  These  cells  contain  large  nuclei 
which  in  some  cases  completely  fill  the  cell  body.  Some  cells 
have  two  nuclei,  and  like  Peters  (1.  c.  page  15.),  I  was  able  to 
observe  signs  of  karyokinesis  in  them. 


36  THE    MUCOUS    MEMBRANE    ELEVATION. 

In  the  vicinity  of  the  capillaries  and  larger  blood  vessels,  which 
are  enormously  dilated  and  in  some  places  ruptured,  we  find  many 
red  blood  corpuscles  lying  between  the  decidual  cells. 

In  this  way  the  somewhat  exaggerated  histologic  picture  of 
hyperemia  and  actual  suffusion  of  the  mucous  membrane  (com- 
pare Fig.  25.  Section  142)  is  formed,  not  unlike  that  described 
as  occurring  during  menstruation,  by  the  author1,  later  by.Geb- 
hard2,  and  recently  by  Sellheim.3 

Between  the  blood  vessels  and  glands  the  decidual  tissue  is 
distributed  partly  in  fine  and  coarse  bands,  partly  in  form  of  an 
outstretched  network  and  there  is  as  yet  no  distinction  possible 
between  a  decidua  compacta  and  decidua  spongiosa,  since  we 
find  thick  compact  layers  and  broad  bands  of  decidual  tissue  in 
the  superficial  as  well  as  the  deeper  layers  of  the  mucosa. 

Noteworthy  is  the  wealth  of  glands  and  their  course.  In  the 
sections  on  either  side  of  the  ovum  (Sections  1  to  30  and  120 
to  160)  some  of  the  glands  can  be  followed  in  their  entire  length 
up  to  their  entrance  into  the  uterine  cavity  (Fig.  3,  Section  4. 
Fig  25,  Section  142).  At  the  opening  and  in  the  middle  they 
are  often  greatly  dilated.  Here  their  walls  are  folded,  forming 
larger  and  smaller  waves  which  like  papillae  protrude  into  glan- 
dular lumen  and  suggest  the  picture  of  a  beginning  adenoma 
In  the  deeper  portions  the  glands  are  lined  with  a  perfectly  pre- 
served cylindrical  epithelium  which  however  becomes  more  dis- 
tinctly cuboidal  the  closer  the  glands  approach  the  base  of  the 
peripheral  wall  of  the  ovular  chamber. 

Since  the  latter  is  made  up  of  blood  spaces,  as  will  be  dem- 
onstrated later,  the  surrounding  decidual  tissue  also  is  'infiltrated 
with  blood,  as  can  be  seen  in  Fig.  25,  Section  142  (Plate  XV  bl.). 

As  a  result  of  this  mucosa  hemorrhage  the  glands  in  the  imme- 
diate vicinity  of  the  ovum  also  are  filled  with  red  blood  cells  and 
are  in  a  state  of  partial  dissolution  exactly  like  during  menstrua- 
tion.* The  epithelium  loosens  from  the  glandular  walls  and 
disappears  among  the  blood  corpuscles.  The  delicate  connec- 
tive tissue  of  the  gland  wall  becomes  loosened -and  is  dissolved; 
the  further  the  ovular  envelope  moves  toward  the  periphery,  the 
more  the  glands  become  displaced.  Their  outer  walls  are  flat- 
tened, their  inner  walls  dissolved.  Certain  sections  (37  to  105) 
show  this  process  very  plainly.  It  is  best  observed  by  following 
the  three  longest.  The  one  in  shape  of  an  arch,  reaches  the 
ovum  and  partly  encircles  it,  the  second  passes  to  the  right,  the 

1  Leopold,  Studien  ueber  die  LTterus  Schleimhaut  (Archiv.  f.  Gynaek    Bd.  XI). 

2  Gebhard.  —  Pathol.  der  Weibl.  Geschlechtsorgane. 

3.  Sellheim-Nagel.     Handbuch  der  Phy«iol.  des  Menschen,  II  1,  pages  96  to  98.     Figs. 
38-41. 

4.  Nagel.  1.  o.  Fig.  41. 


THE    MUCOUS    MEMBRANE    ELEVATION.  37 

middle  one  ends  blindly  near  the  ovum  and  as  its  cavity  expands, 
gradually  disappears. 

The  Figs.  14  (Plate  VIII)  and  23  (Plate  XIII)  show  espe- 
cially the  arches  formed  by  the  left  and  right  glands.  In  Fig. 
22  (Plate  XII)  we  see  only  a  trace  of  the  end  of  the  middle 
gland,  whereas  in  Fig.  24  (Plate  XIV)  the  section  165,  which 
lies  further  away  from  the  ovum  proper,  again  shows  the  end 
of  the  middle  gland,  which  is  dilated  and  filled  with  blood, 
(dr.) 

From  this  can  be  seen  that  the  glands  are  considerably  dilated 
and  hypertrophied.  The  "Eianlage"  acts  as  a  foreign  body  and 
presses  the  glands  toward  the  wall.  The  "Eianlage"  furthermore, 
together  with  the  free  extravasated  red  blood,  destroys  and  dis- 
solves glands  and  thus  helps  to  form  the  intercommunicating 
blood  spaces  of  which  we  will  presently  speak.  None  of  the  sec- 
tions furnished  any  proof  for  the  assumption  that  the  glands  open 
directly  into  the  ovular  chamber,  or  that  the  ovum  entered  the 
mucosa  through  the  mouth  of  a  dilated  gland.  No  signs  were 
found  of  any  well  preserved  glandular  epithelium  or  even  rests 
of  such  lining  this  cavity.  This  is  furthermore  made  improbable 
since,  as  we  have  seen  before,  the  glands  in  their  entirety,  includ- 
ing the  walls  and  epithelium  in  the  immediate  vicinity  of  the . 
ovum,  are  dissolved  as  the  result  of  its  growth. 

The  mucous  membrane  elevation  and  all  the  adjoining  tissue 
down  to  the  muscularis,  is  very  vascular.  The  structure  and 
course  of  the  blood  vessels  during  the  first  weeks  of  pregnancy 
have  been  carefully  described  in  a  number  of  excellent  works 
and  we  refer  to  them  for  further  information.  Here  only  those 
facts  shall  be  emphasized  which  seem  most  important  in  connec- 
tion with  the  very  earliest  stage  of  pregnancy.  Since  they  are 
dealt  with  only  in  the  work  of  Peters,  a  confirmation  or  further 
elaboration  of  his  contribution  would  seem  very  desirable. 

In  the  deeper  portions  of  the  mucosa,  especially  in  the  thicker 
layer  of  the  decidual  trabeculae,  one  still  meets  with  little  arteries 
twisted  like  cork  screws.  As  a  rule  they  are  found  cut  either 
transversely  or  lengthwise,  the  latter  often  accompanying  the 
glands  for  a  long  distance.  On  cross  section  the  capillaries  show 
around  their  endothelial  lining  a  second  and  sometimes  a  third 
delicate  ring  of  endothelium.  The  closer  the  ovum  is  approached, 
the  greater  becomes  the  number  of  capillaries  and  the  greater  is 
their  distention  and  the  extravasation  of  red  blood  cells  into  the 
surrounding  tissue.  .If  the  delicate  wavy  walls  of  these  distended 
capillaries  are  carefully  examined,  it  will  be  seen  that  at  certain 
places  there  are  defective  areas  or  even  tears,  through  which  the 


38  THE    MUCOUS    MEMBRANE    ELEVATION. 

erythrocytes  escape  into  the  adjoining  tissue.  They  loosen 
the  glands  and  detach  the  swoolen  epithelium  which 
now  lies  crumbled  in  the  gland  duct.  In  this  way  a  coalescence 
of  glands  and  capillaries  is  effected  which  in  the  neighborhood 
of  the  ovum  results  in  the  continuous  formation  of  new  inter- 
communicating blood  spaces.  If  Figs.  7  and  8  ('Plate  IV) 
marked  "c,"  are  carefully  studied,  this  process  can  be  better 
understood  than  describing  the  same.  Figure  14  (Plate  VIII) 
is  still  better,  in  which  c  and  c±  indicate  the  adjoining  cavities 
filled  with  blood. 

The  confluent  blood  spaces  are  best  seen  in  Fig.  22  (Plate 
XII)  where  "c"  shows  fine  septa  as  the  remains  of  the  tissue 
which  at  first  separated  the  glands  from  the  capillaries.  As  the 
"Eianlage"  grows  these  septa  become  still  thinner  and  are  finally 
completely  dissolved,  so  that  at  "c"  the  blood  spaces  are  in  direct 
communication  with  their  neighbors  cl  and  c2,  and  the  latter 
again  with  the  ovular  chamber  and  its  blood  spaces.  Attention 
is  here  called  to  the  fact  (which  later  on  will  be  dealt  with  in 
detail),  that  the  trophoblast  processes  have  anchored  themselves 
to  the  walls  of  these  spaces  at  cx  and  c2.  Thus  it  is  self-evident 
that  in  the  entire  periphery  of  the  ovum  these  trophablast  pro- 
cesses are  surrounded  and  nourished  by  connecting  blood  spaces. 
These  conditions  are  seen  more  distinctly  in  section  94  (Fig.  23, 
Plate  XIII).  At  "c"  a  broad  blood  space  runs  almost  parallel 
with  the  glands  to  the  ovular  chamber.  At  cl  another  one  passes 
from  the  left  inward  and  breaks  up  into  several  blood  spaces 
which  communicate  with  the  ovular  chamber.  It  is  best  seen 
at  c2,  where  a  dilated  capillary,  running  to  the  left  and  upwards, 
like  through  a  slit,  appears  in  the  cavity. 

A  striking  similary  is  obvious,  if  we  compare  these  pictures 
with  those  in  my  atlas  ("Uterus  und  Kind"  plate  VI)  illustrat- 
ing injected  intervillous  spaces  in  the  fifth  month  of  pregnancy, 
which  communicate  with  vessels  of  the  serotina. 

It  seems  justifiable  to  deduce  from  Figs.  22  and  23,  that  al- 
ready in  the  first  days  of  pregnancy,  as  described  by  Peters  and 
myself,  the  capillaries,  through  their  dilatation,  their  breaking 
up  into  the  surrounding  tissue  and  their  dissolution  into  enor- 
mous blood  spaces  which  communicate  with  the  ovular  chamber, 
form  the  first  rudiments  of  the  intervillous  spaces. 

How  do  these  statements  compare  with  those  of  Peters,  Graf 
von  Spec  (1.  c.  pg.  2.)  and  the  various  researches  made  on  ani- 
mals, as  compiled  by  Pfannenstiel1?  In  this  early  stage  Peters 
has  also  observed  decidual  cells.  He  could  not  find  a  sharp  di- 
vision in  the  mucosa  between  a  compacta  and  spongiosa. 

1  Winckel.     Handbuch  der  Geburtshilfe.     Bd.  I.   1,  pg.  194. 


THE    MUCOUS    MEMBRANE    ELEVATION.  39 

The  mucous  membrane  elevation  in  which  his  ovum  lies,  pro- 
trudes but  slightly  and  still  has  a  superficial  epithelium  covering 
its  margin.  The  glands  are  greatly  dilated,  lie  around  the  ovum 
meridionally  and  also  have  no  communication  with  the  ovular 
chamber,  the  latter  pressing  them  aside.  In  his  sections  also  vari- 
ous uterine  glands  (Plate  I)  are  seen  filled  with  blood,  the  sur- 
rounding of  the  ovum  containing  an  enormous  wealth  of  greatly 
dilated  capillaries  which  in  part  are  changed  .into  wide  blood 
spaces  exactly  as  in  my  specimen.  In  his  Plate  I,  a  large  blood 
space  is  seen  to  the  right  and  below,  like  an  extravasation  sur- 
rounding almost  half  the  periphery  of  the  ovum,  communicating 
freely  with  those  blood  lacunae  in  which  the  trophoblastic  pro- 
cesses are  directly  immersed. 

Although  the  similarity  between  Peters'  and  my  specimen  is 
striking,  still  attention  must  be  called  to  certain  apparently  ex- 
isting differences.  In  Peters'  specimen  the  trophoblast  every- 
where lies  in  direct  contact  with  the  inner  wall  of  the  envelope 
of  the  ovum  and  an  embryonic  rudiment  is  plainly  visible.  In 
my  specimen,  on  the  other  hand,  the  trophoblast  has  not  as  yet 
everywhere  reached  the  inner  wall.  It  still  partly  floats,  in  the 
blood  which  fills  the  ovular  chamber.  In  spite  of  repeated  and 
careful  examinations  no  trace  of  an  embryonic  formation  could 
be  detected. 

Whether  this  floating  of  the  trophoblast  in  the  blood  of  the 
ovular  chamber  and  the  absence  of  an  embryonic  "Anlage"  is  pos- 
sibly only  due  to  a  pathological  extravasation  of  blood  between 
the  ectoblast  and  mesoderm,  is  still  a  question  which,  must  be 
decided  later.  This  difference,  which  in  this  connection  is  simply 
registered,  is  striking  and  might  warrant  the  question,  whether 
the  ovum  in  my  specimen  is  not  possibly  a  few  hours  younger 
than  that  of  Peters,  and,  whether  within  the  next  one-half  day  the 
junction  between  the  trophoblast  and  the  inner  wall  of  the  ovular 
envelope  would  not  have  been  completed.  This,  however,  must 
'remain  a  mere  assumption  until  other  specimens  of  such  an  early 
stage  have  been  found. 

At  any  rate  the  same  vascularity  which  is  observed  in  our  two 
specimens,  is  also  found  in  the  uteri  of  animals.  "The  changes 
in  the  maternal  mucosa  surrounding  the  ovum,  in  the  various 
mammalia,  are  differently  described.  A  formation  of  new  ves- 
sels in  the  immediate  neighborhood  of  the  chorion,  often  to  a 
great  extent,  is  regularly  found.  In  advanced  stages  noticeable 
vascular  changes  also  occur  in  the  deeper  layers  of  the  mucous 
membrane1." 

"Very  important  are  the  results  of  researches  made  on  animals 


1  Pfannenstiel  in  Winekel  1.  c.  pg.  198. 


40  THE    MUCOUS    MEMBRANE    ELEVATION. 

regarding  the  first  relation  between  the  surface  of  the  ovum  and 
the  vascular  system  of  the  maternal  mucosa.  This  relation  is 
established  very  early,  both  in  the  insectivora  and  the  rodents. 
The  ectoblast  thickens  at  the  placental  site  by  the  formation  of 
numerous  layers  and  lacunae  soon  form  which  become  filled  with 
maternal  blood.  The  manner  in  which  the  blood  gains  access  to 
these  spaces  is  not  sufficiently  understood,  but  it  is  certain  that 
the  new  formation  of  maternal  blood  vessels  near  the  ectoblast 
is  enormous  and  that  from  them  the  ectoblast  lacunae  receive  their 
blood  supply." 

"The  maternal  blood  from  the  very  beginning  remains  in  a 
closed  channel  and  in  regular  circulation.  Frommel  has  demon- 
stated  the  same  conditions  in  the  bat.  In  the  carnivora,  e.  g.,  the 
cat,  these  maternal  vessel  walls  are  also  preserved  in  the  pla- 
centa. The  significance  of  this  fact  for  human  placentation  is 
evident.  In  animals  the  "intervillous"  spaces  appear  very  early; 
they  are  filled  with  blood  from  the  very  beginning  and  are  in  con- 
stant and  lasting  communication  with  the  maternal  blood  vessels. 
These  same  conditions  no  doubt  also  prevail  in  the  human." 

From  the  above  description  this  presumption  is  proved  a  cer- 
tainty, even  for  the  earlier  stages  of  the  human  ovum. ' 

The  vascularity  of  the  mucosa  in  my  specimen,  in  its  relation 
to  menstrual  conditions,  is  still  another  subject  worthy  of 
consideration  in  this  chaper 

.Peters  estimates  the  age  of  his  ovum  as  from  3  to  4  days  by 
assuming  a  relation  between  it  and  the  menstruation  which  for 
the  first  time  had  just  failed  to  appear.  He  bases  his  assump- 
tion on  the  history  of  the  case  and  on  the  histological  condition 
of  the  decidua,  which,  "in  every  respect  resembles  the  description 
given  of  decidua  menstrualis  immediately  preceding  menstrua- 
tion." 2 

From  the  history  Peters  endeavors  to  show  that  on  the  day  of 
her  suicide  (October  1st)  the  pregnant  woman  was  about  to 
menstruate.  From  the  state  of  development  of  the  Eianlage  and 
the  entire  ovum  itself,  no  other  conclusion  could  be  drawn,  save 
that  this  represented  the  impregnated  ovum  of  the  expected  men- 
struation. Based  on  these  facts  he  estimated  the  age  of  the 
ovum  as  possibly  three  to  four  days. 

Although  I  agree  with  Peters  in  regard  to  the  manstruation- 
like  appearance  of  the  mucosa,  I  cannot  coincide  with  him  in  his 
calculations  from  the  history  of  the  case. 

We  read'  on  page  3  of  Peters'  work  that  the  woman  had  her 
last  normal  menstruation  on  September  1st,  1895.  At  the  end 
of  September  (on  September  28th,  according  to  the  normal  type, 

1  Pfannenstiel  1.  c.  pg.  200. 

2  Peters  1.  c.  pg.  16. 


' 
THE    .MUCOUS    MEMBRANE    ELEVATION.  41 

and  no  statement  to  the  contrary  is  made)  the  menses  should 
have  reappeared.  They  did  not,  however,  return  at  the  ex- 
pected time,  and  the  woman,  fearing  pregnancy,  committed  sui- 
cide on  October  1st.  This  would  be  3  to  4  days  after  the  ex- 
pected appearance  of  the  menses.  Or,  if  we  assume  from  certain 
observations  that  the  ovule  escapes  from  the  matured  follicle 
about  two  days  before  menstruation,  the  suicide  was  committed 
five  to  six  days  after  the  expulsion  of  the  ovum  from  the  follicle 
and  the  impregnated  ovule  presumably  would  then  be  five  to 
six  days  old.  Probably  it  is  only  a  lapsus  calami  when  Peters 
on  page  16  states,  that  the  woman  was  about  to  menstruate  on 
the  day  of  the  suicide ;  he  should  have  said  that  her  death  oc- 
curred about  three  to  four  days  after  the  expected  menstruation, 
which  for  the  first  time  had  failed  to  appear. 

Whether  or  not  this  ovum  be  four  or  six  days  old  does,  how- 
ever, not  in  the  least  diminish  the  value  of  this  specimen,  for 
by  its  examination  Peters  has  certainly  succeeded  in  throwing 
new  light  on  the  embedding  theory  of  the  human  ovum. 

An  accurate  idea  of  the  respective  age  of  such  ova  we  shall 
have  only  after  more  such  small  ova  have  been  described,  of  cases 
in  which  absolutely  reliable  histories  have  been  obtained.  At 
present  one  seems  justified  in  associating  his  specimen  with  the 
first  missing  menstruation. 

The  same  surely  holds  true  of  my  specimen,  even  without  a 
history,  since  there  is  not  even  a  suggestion  of  a  embryonic 
rudiment,  of  an  amnion,  etc.,  present,  as  was  found  .in  'Peters' 
ovum. 

I  am,  however,  willing  to  refrain  from  making  any  estimate  of 
the  age  of  my  ovum.  Later  investigators  who  may  have  the 
good  fortune  to  work  with  reliable  specimens  of  cases  in  which 
accurate  histories  are  obtainable,  may  then  determine  the  age  of 
my  specimen. 

Of  a  very  similar  character  is  also  the  ovum  demonstrated  by 
Graf  von  Spec  in  Kiel  in  1905.  It  also  comes  from  a  woman 
who  committed  suicide  by  taking  oxalic  acid.  "The  mucosa  of 
the  uterine  body,  as  is  characteristic  for  pregnancy,  was  divided 
into  irregular  areas  by  deep  furrows.  One  field  immediately  in 
front  of  the  right  tubal  opening,  on  the  anterior  wall,  was  more 
prominent  and  had  an  umbilication  with  a  marked  discoloration. 
This  aroused  the  suspicion  of  being  the  nidus  of  the  ovum.  His- 
tologic  sections  made  of  this  portion  of  the  mucosa  proved  to  be 
very  satisfactory  for  examination  and  on  demonstration  through 
the  epidiascope  showed  the  following  condition :  Taking 
up  about  two-thirds  of  the  free  surface  of  this  prom- 


42  THE  EMBEDDING  OF  THE  OVUM. 

inent  mucosa  area,  in  a  cavity  of  the  interglandular  connective 
tissue  of  the  mucosa,  an  ovum  1.5  x  2.5  mm.  was  situated.  It 
had  but  few  villi  and  contained  an  embryo  in  a  very  rudimentary 
stage.  Between  the  surfaces  of  the  chorion  and  uterine  tissue, 
here  and  there,  small  quantities  of  blood  could  be  seen  which  es- 
caped from  ruptured  vessels.  The  walls  of  the  ovular  chamber 
•were  entirely  made  up  of  elements  of  the  interglandular  connec- 
tive tissue.  All  the  glands  opened  into  the  uterine  cavity,  none 
into  the  ovum  chamber.  Like  the  ovum  of  Peters,  the  serotina, 
i.  e.,  the  mucosa,  between  the  ovum  and  uterine  muscularis,  con- 
tained, within  greatly  dilated  endothelial  tubes,  large  blood  clots 
apparently  formed  still  during  life.  This  blood  served  a  double 
purpose,  furnishing  nutriment  to  the  ovum  and  protecting  the 
deeper  portions  of  the  mucosa  against  the  corrosive  action  of  the 
ovum.  That  portion  of  the  envelope  of  the  ovum  which  separ- 
ates the  cavum  of  the  uterus  from  that  of  the  ovum,  consisted  of 
a  thicker  or  thinner  layer  of  interglandular  connective  tissue  cov- 
ered towards  the  uterine  lumen  by  a  single  stratum  of  epi- 
thelium." 

Thus  it  can  be  seen  that  also  in  this  specimen  the  ovular  en- 
velope is  formed  by  decidual  tissue,  none  of  the  uterine  glands 
open  into  it,  and  near  the  ovum,  especially  in  the  serotina,  large 
blood  masses  lie  in  immensely  dilated  endothelial  tubes. 


II. 

THE  EMBEDDING  OF  THE  OVUM.    THE  CAPSULARIS. 
THE  FIBRIN  COVER  ("GEWEBSPILZ  OF  PETERS"). 

Since  it  has  been  established  by  Graf  von  Spec  for  the  guinea 
pig  and  by  Peters  for  the  human  being,  that  the  ovule  bores  its 
way  through  the  surface  of  the  mucosa,  it  has  become  the  duty 
of  the  later  investigators  to  determine  whether  this  is  the  only 
mode  of  nidation  or  whether  not  occasionally  a  circumvallation 
occurs  arising  from  the  mucosa  surrounding  the  ovum. 

Pfannenstiel  1.  c.  page  194,  is  correct  in  saying:  "The  ovum  de- 
scribed by  Peters  is  already  completely  or  almost  completely  en- 
veloped by  the  mucous  membrane.  In  spite  of  the  great  value  of 
this  specimen,  in  spite  of  the  fact  that  it  has  revolutionized  our 
views  concerning  ovular  nidation,  we  should  not  forget  that  this 
is  the  only  specimen  extant  of  this  early  stage  of  development  and 
it  would  seem  advisable  not  to  go  too  far  in  its  interpretation." 


THE  EMBEDDING  OF  THE  OVUM.  43 

Which,  then,  are  the  similarities  and  which  the  differences  be- 
tween mine  and  'Peters'  specimen  ? 

First  of  all,  it  is  to  be  noted  that  the  mucosa  elevation  on  the 
sides  of  the  ovule  almost  up  to  the  fibrin  cover,  is  still  covered 
with  a  surface  epithelium  (Fig.  3.  e.  Plate  II). 

Close  to  the  fibrin  cover  the  epithelium  becomes  irregular,  is 
partly  swollen  and  partly  detached.  In  some,  sections  (Figs.  7  & 
9,  e,e,  'Plates  IV  &  V)  it  extends  like  in  Peters'  specimen  (Plate 
I  U.E.)  under  the  fibrin  cover,  as  a  narrow  band.  At  the^  slope 
towards  the  furrow  (F)  it  is  practically  absent. 

Special  stress  is  to  be  laid  on  the  fact  that  under  the  center 
of  the  fibrin  cover  where  it  lies  closest  to  the  summit  of  the 
ovum,  no  more  regular  surface  epithelium  is  met  with.  Like- 
wise nowhere  within  the  ovular  chamber  can  even  a  trace  of 
epithelial  lining  be  found  which  connects  with  the  surface  epi- 
thelium. 

One  peculiar  condition  which  appears  only  in  the  sections  15-19 
(Figs.  5  &  6  Plate  III)  must  be  described. in  detail.  To  the 
right,  below  the  center  of  the  fibrin  cover,  a  depression  (e.  s.) 
is  noticed  which  is  lined  by  a  few  cuboidal  cells  (Fig.  5)  whose 
resemblance  to  epithelial  cells  cannot  be  denied.  Among  them, 
however,  are  a  few  broader  cell  bodies  with  large  nuclei  which 
are  not  unlike  syncytial  cells.  This  supposition  is  strengthened 
by  the  fact  that  with  high  magnification  one  can  see  a  few  large 
syncytial  cells  extending  from  the  nearest  trophoblast  plugs  to- 
wards the  depression  e.  s.  (More  details  will  be  given  in  a  later 
description  of  the  trophoblast,  Fig.  10.) 

This  funnel  shaped  depression  is  still  distinctly  visible  in  Fig. 
6  at  e.  s.  Here,  however,  it  is  filled  with  red  blood  cells  which 
have  escaped  from  the  ovum  chamber  and  in  their-  further  course 
cannot  be  differentiated  from  the  blood  cells  which  infiltrate  the 
structureless  fibrin  mass.  (Fi.) 

This  funnel  shaped  depression  seems  worthy  of  special  note 
and  probably  deserves  to  be  particularly  considered  in  all  fu-" 
ture  investigations.  It  is  certainly  the  only  visible  and  partly 
preserved  connection  between  the  ovular  chamber  and  the  uter- 
ine cavity. 

What  will  be  its  significance?  It  might  be  regarded  as  the 
remains  of  a  glandular  orifice,  yet  much  speaks  against  this.  First 
of  all  there  is  no  gland  opening  anywhere  within  a  wide  area  of 
this  spot,  especially  outside  of  the  fibrin  cover.  Naturally  so, 
since  the  glands  have  been  displaced  by  the  ovum  and  lie  more 
meridionally.  We  have  already  shown  that  the  glands  do 
not  take  any  direct  part  in  the  formation  of  that  cavity  which 


44  THE  EMBEDDING  OF  THE  OVUM. 

harbors  the  ovum  and  that  this  chamber  nowhere  in  its  interior 
carries  a  lining  of  uterine  epithelium.  If  this  funnel  was  ac- 
tually a  gland  orifice  the  good  preservation  of  its  cells  would  be 
striking  in  contrast  to  the  glandular  openings  still  visible  to  the 
sides  of  the  ovum,  since  their  epithelial  cover  consists  almost 
only  of  swollen,  detached  and  liquified  cells. 

The  question  suggests'  itself,  however,  whether  this  funnel 
shaped  depression  does  not  indicate  the  site  where  the  ovum  has 
entered  the  mucosa.  My  ovum  does  not  show  any  "Anlage"  of 
an  embryo  and  therefore  must  be  younger  than  that  of  Peters, 
in  which  an  amniotic  cavity  with  an  exocoelum  is  distinctly  vis- 
ible. The  assumption  may  be  justified  that  my  ovum  has  just  ac- 
complished its  nidation  and  is  about  to  become  sufficiently  an- 
chored to  the  ovular  envelope  by  sending  out  trophoblastic  pro- 
cesses. The  fact  that  this  place  at  e.  s.  represents  the  only 
visible  connection,  obviously  leads  to  the  question,  whether  or 
not  the  ovum  has  possibly  here  entered  the  mucosa.  This  place 
is  certainly  about  to  become  obliterated  by  the  encroachment  of 
decidual  cells  from  both  sides,  but  there  is  still  a  relation  extant 
between  the  interior  and  exterior.  At  a  place  within  the  blood 
filled  space  of  the  ovular  chamber  lying  closest  to  the  depression 
e.  s.  (in  Fig.  6),  an  escape  of  red  blood  cells  can  be  followed,  one 
sees  how  they  collect  at  e.  s.  and  from  here  permeate  the  fibrinous 
cover.  Thus  one  seems  justified  in  assuming  that  also  the  fibrin- 
ous cover  has  originated  here,  that  it  serves  more  or  less  as  a 
lid  and  that  it  is  supplied  with  red  blood  cells  until  the  envelope 
completely  surrounds  the  ovum. 

Before  the  structure  and  development  of  this  fibrinous  cover 
is  considered  in  detail,  the  process  of  embedding  of  the  ovum, 
and  the  ovular  chamber  must  be  considered.  In  all  sections 
(Figs.  14,  22  &  23,  Plate  VIII,  XII  &  XIII)  the  decidua  com- 
pletely surrounding  the  ovum,  shows  the  indentical  histological 
structure.  Although  varying  in  thickness  at  different  places, 
especially  at  the  summit  of  the  ovum  and  at  both  sides  of  the 
mucosa  elevation,  the  decidua  everywhere  consists  of  thin  wavy 
fibres  containing  larger  and  smaller  decidua  cells,  numerous  cap- 
illaries and  a  large  number  of  extravasated  red  blood  cells.  One 
can  therefore  not  say  that  the  mucosa  has  reflected  itself  from 
the  two  sides  over  the  ovum,  lying  in  its  chamber,  nor  can  as- 
sert, that  a  scar  can  be  seen  on  the  summit  of  the  ovular  ele- 
vation. 

Everything  points  rather  to  the  fact,  which  has  been  proved 
by  Peters,  that  the  ovum  has  burrowed  its  way  into  the  mucosa, 
in  our  specimen  somewhat  asymmetrically  in  a  mucosa  eleva- 


THE  EMBEDDING  OF  THE  OVUM.  45 

tion.  The  point  of  entrance  in  our  case  has  become  almost  com- 
pletely obliterated,  but  there  still  persists  a  narrow  channel  from 
which  some  blood  oozes,  the  latter  accumulates  at  the  summit  of 
the  ovum  and  becomes  transformed  into  the  fibrinous  cover. 

It  Peters'  specimen  the  connective  tissue  does  not  as  yet  form 
so  complete  an  envelope  as  in  mine,  in  which  the  ovum  has 
possibly  already  penetrated  to  a  greater  depth.  In  his  case,  there- 
fore, the  opening  still  existing  in  the  decidual  envelope  is  covered 
by  a  broad  layer  of  fibrin  partially  organized.  It  is  called  by  him 
the  "Gewebspilz."  The  trophoblastic  processes  with  their  syn- 
cytial  excrescences  are  directly  attached  to  it 

Concerning  the  clos.ure  of  the  defect  through  which  the  ovum 
has  penetrated,  'Pfannenstiel  (1.  c.  page  220)  has  expressed  him- 
self very  carefully.  Since  at  that  time  Peters'  specimen  was  the 
only  one  known,  he  considered  the  process  of  closure  as  uncer- 
tain. Descriptions  of  very  young  ova  as  given  by  Peters,  Graf  von 
Spec,  Heukelom,  Leopold  and  Keibel  had  stated  "that  at  the  point 
of  closure  not  a  distinct  decidual  tissue  but  a  scar  tissue  is  found, 
consisting  chiefly  of  fibrin  and  showing  an  absence  of  blood  ves- 
sels, also  he  himself  was  able  to  confirm  the  presence  of  this 
fibrinous  scar  tissue,  he  would  not  consider  this  question  defin- 
itely settled  since  the  formation  of  fibrin  within  the  decidual 
envelope  of  the  ovum  is  very  common  and  often  can  be  traced 
to  an  entirely  different  cause.  It  would  seem  possible  that  the 
final  closure  of  the  decidual  capsule  around  the  ovum  is  accom- 
plished by  a  firm  coalescence  of  the  vascular  connective  tissue 
which  proliferates  from  opposite  sides.  At  this  place,  which  is 
the  most  poorly  nourished  portion  of  the  reflexa,  soon  after- 
wards signs  of  degeneration  would  appear  especially  so  in  ova 
which  are  more  superficially  embedded.  The  blood  plug  of 
Peters  thus  might  possibly  be  considered  an  abnormal  condition.'' 

The  assumption  of  Pfannenstiel  that  the  ovum  has  an  entirely 
decidual  envelope  is  confirmed  by  my  case,  with  the  exception 
of  that  narrow  opening  at  e.  s.  As  mentioned  before,  it  is 
caused  by  a  deeper  implantation  of  the  ovum.  Nevertheless,  there 
is  in  our  case,  like  in  that  of  Peters,  a  large  and  very  broad 
fibrinous  cover  lying  over  the  top  of  the  ovum,  so  that  such  a 
cover  must  form  even  in  case  of  complete  decidual  inclusion.  In 
any  explanation,  however,  of  the  origin  of  this  fibrinous  cover 
one  must  consider  this  narrow  opening  through  which  the  ovum 
sank  (e.  s.  Fig.  5  &  6)  and  whence  that  tiny  amount  of  blood 
has  oozed  to  the  surface  and  there  coagulated. 

In  order  to  obtain  a  clear  conception  of  this  fibrinous  lid  one 
must  first  of  all  gain  a  precise  idea  of  its  form,  length,  width  and 


46  THE  EMBEDDING  OF  THE  OVUM. 

structure.  It  can  be  seen  in  the  microscopic  sections  from  10 
to  70,  then  again  from  75  to  103  and  a  trace  of  it  finally  in  section 
119. 

The  entire  160  microscopic  sections  are  embedded  so  that  the 
slope  of  the  mucosa  elevation  with  the  furrow  (F)  lies  to  the 
right  of  the  specimen  and  all  illustrations  follow  the  same  rule. 
It  will  thus  be  perfectly  plain,  if  in  describing  this  fibrinous 
cover  the  term  "left,"  applies  to  the  direction  toward  the  uterine 
fundus,  the  term  "right,"  toward  the  slope  of  the  mucosa  ele- 
vation and  the  furrow  (F). 

If  for  the  purpose  of  reconstruction,  the  various  sections  are 
placed  together,  one  receives  the  impression,  in  a  view  from 
above,  that  two  minute  drops  of  coagulated  blood  lie  on  the  mu- 
cosa elevation  near  its  slope.  The  larger  drop  lies  more  towards 
the  right  edge  of  the  uterus,  the  smaller  and  flatter  one  to  the 
left.  Still  farther  to  the  left  in  section  119  a  trace  of  a  coagu- 
lated mass  can  be  seen. 

All  sections  through  the  larger  drop  show  its  right  half  con- 
siderably thicker  and  more  voluminous  than  the  left.  On  the  sec- 
tions through  the  center,  the  fibrin  appears  in  rolled  up  waves 
like  a  congealing  substance.  (Figs.  7,  9,  11,  14,  15.  Plates  IV, 
V,  VII.  VIII.  IX.)  In  explaining  this  condition  one  must  con- 
sider that  this  thicker  portion  is  situated  exactly  over  the  fine 
fissure  (e.  s.)  through  which  blood  is  still  oozing  from  the 
ovular  chamber.  On  the  other  hand  one  must  keep  in  mind  that 
the  escaping  drop,  both  in  the  lying  or  standing  position  of  the 
woman,  must  gravitate  downwards,  i.  e.,  in  the  direction  of  the 
slope  of  the  mucosa  elevation. 

The  size  and  structure  of  the  fibrinous  cover  as  well  as  its  re- 
lation to  the  ovular  chamber  can  be  best  understood  from  a 
study  of  some  of  the  illustrations.  In  section  10  (Fig.  4,  Plate 
II)  the  cover  suddenly  appears.  It  has  the  shape  of  an  oblong 
cylinder,  somewhat  thicker  to  the  right,  whose  left  lower  edge 
is  intimately  connected  with  the  decidual  envelope  of  the  ovum. 
From  the  left  some  surface  epithelial  cells,  already  irregular, 
penetrate  under  the  edge  of  the  cover  (e).  On  its  surface  lies 
a  band  varying  in  thickness  that  possibly  consists  of  surface  epi- 
thelia  of  the  mucosa,  which,  however,  are  not  discernable  as  such. 
The  cover  itself  consists  of  a  mass  of  fibrin  in  which  here  and 
there  white  and  red  blood  corpuscles  are  met  with. 

Almost  identical  conditions  are  found  in  sections  15  and  19 
(Figs.  5  and  6  Plate  III),  only  that  in  Fig.  5,  in  the  band  on  the 
surface,  a  few  cuboidal  epithelia  can  be  seen,  whose  origin  T 
failed  to  determine. 


THE    EMBEDDING    OF'  THE    OVUM.  47 

In  sections  22  (Fig.  7)  and  27  (Fig.  8  'Plate  IV)  the  fibrinous 
cover  appears  in  a  considerably  changed  form.  Like  a  catter- 
pillar  with  a  large  head,  it  lies  on  the  ovular  envelope,  which  has 
become  thinner.  Under  its  right  and  left  edge  (Fig.  7)  traces 
of  surface  epithelium  are  seen.  Its  superficial  portion  contains 
a  few  white  blood  cells,  in  its  interior  a  delicate  network  of 
fibres.  Most  conspicuous,  however,  is  the  folded  appearance  of 
the  coagulated  .mass  to  the  right  (Fig.  8  fi)  which  depresses  the 
ovular  envelope. 

These  conditions  are  most  plainly  visible  in  Fig.  9  (Plate  V) 
and  Fig.  11  (Plate  VII).  In  the  latter,  representing  section  30, 
at  fi.,  fibrinous  masses,  like  frozen  waves,  are  heaped  one  upon 
the  other,  causing  a  deep  indentation  of  the  walls  of  the  ovular 
chamber.  In  Fig.  13  the  fibrinous  masses  contain  a  large  amount 
of  white  blood  cells,  still  more  of  them  in  Figs.  16  and  17,  while 
in  Fig.  15  the  clubbed  end  of  the  cover  is  the  thickest.  Here 
over  the  depressed  portion  of  the  ovular  envelope  the  fibrinous 
masses  are  arranged  exactly  like  in  a  corpus  luteum  in  the  stage 
of  organization. 

Gradually  the  arrangement  and  signs  of  an  organization  make 
their  appearance  in  the  fibrin  cover  in  form  of  connective  tissue 
fibrils.  Thus  a  sort  of  new  formed  protective  layer  develops 
over  a  portion  of  the  ovular  envelope.  This  portion  in  itself  is 
very  thin,  but  is  further  weakened  by  trophoblastic  processes 
which,  as  will  be  described  later,  for  the  purpose  of  fixing  the 
Eianlage,  have  penetrated  into  the  summit  of  the  ovular  cham- 
ber. (Compare  Peters.) 

The  formation  of  a  protective  cover  for  which  the  escaping 
blood  droplets  have  been  utilized,  must  be  regarded,  as  has  al- 
ready been  emphasized  by  Peters,  an  exceedingly  important 
process  and  a  wise  provision  of  nature. 

If  Figs.  18  and  19  (sections  68-69)  are  compared  it  will  be 
seen  that  the  left  portion  of  the  fibrinous  band  has  undergone  a 
certain  organization  and  reenforces  the  ovular  envelope.  The 
right  clubbed  shaped  end  is  a  mass  of  twisted  fibrils  which  has 
gradually  decreased  in  size  and  like  a  button  (Fig.  19  kn)  lies 
in  a  depression. 

Since  with  section  70  the  larger  of  the  coagulated  drops  disap- 
pears, it  must  be  assumed  that  the  surface  between  sections  70 
and  75  (Figs.  19  and  20  Plate  XI)  is  free  of  any  fresh  deposit 
of  fibrin,  carries,  however,  the  continuation  of  the  organized 
portion. 

In  section  75  (Fig.  20)  suddenly  a  new  fibrinous  layer  ap- 
pears. To  the  left  of  the  mass,  which  is  in  a  state  of  organiza- 


48  THE    EMBEDDING    OF    THE    OVUM. 

tion,  lies  a  band  varying  in  thickness  which  resembles  the  rests 
of  surface  epithelia  and  extends  upwards  along  the  edge  of  this 
new  fibrinous  cover,  thus  the  observation  described  above  is  prac- 
tically repeated.  Again  the  cover  becomes  oblong  but  in  this 
instance  is  thicker  in  the  middle  portion,  but  in  general  does  not 
attain  the  length  or  thickness  of  the  fibrinous  cover  previously 
described.  There  are  a  few  white  blood  cells  in  its  middle  part. 
With  section  105  this  fibrin  band  has  again  disappeared,  here 
(Fig.  24  Plate  XIV)  the  ovular  chamber  being  cut  more  later- 
ally shows  a  thicker  wall  while  in  the  preceding  sections  the 
fibrinous  cover  seemed  to  play  the  role  of  a  reenforcement  for 
the  ovular  chamber  and  of  a  protective  layer,  as  was  clearly  shown 
in  the  pictures  of  the  first  mentioned  larger  fibrinous  mass. 

Concerning  a  fibrinous  cover  (Gewebspilz)  in  the  ovules  of 
Graf  v.  Spec  (Kiel  1905)  and  of  Beneke,  we  find  the  following 
references :  Van  Spec  says  on  pg.  422 :  "At  the  site  of  the  fun- 
nel shaped  depression  the  uterine  tissue  shows  a  defect  which 
must  be  regarded  the  gate  through  which  the  ovum  entered  the 
endometrium  during  the  process  of  implantation.  This  open- 
ing is  sealed  by  a  flat  blood  coagulum  (fibrin,  containing  leuco- 
cytes and  red  blood  cells).  Thus  the  conditions  are  very  sim- 
ilar to  those  described  by  Peters.  The  opening  which  appears 
with  a  diameter  of  not  more  than  0.8  mm.,  possibly  is  larger 
than  at  first  produced  by  the  ovum.  This  increase  may  be  due  to 
the  stretching  and*  growth,  possibly  also  to  a  histolytic  action 
of  the  ovular  wall." 

Beneke  reports  on  page  772:  "The  tissue  plug  (Gewebs- 
pfropf)  which  closes  and  fills  the  defect  in  the  reflexa  in  general 
corresponds  in  its  histologic  structure  to  that  described  by 
Peters.  It  contains  blood,  fibrin,  leucocytes,  etc." 

After  this  description  one's  attention  obviously  is  again  drawn 
to  the  question  of  the  similarities  and  discrepancies  between  mine 
and  Peters'  ovum. 

Up  to  this  point  both  specimens  are  identical  in  all  essential 
features. 

In  both  we  see  the  decidua  vera  in  a  condition  of  edematous 
infiltration.  In  both  the  ovule  lies  in  a  swollen  mucosa  near  a 
furrow,  in  both  instances  the  ovule  has  penetrated  into  the  mu- 
cosa at  a  place  deprived  of  epithelium  and  has  pushed  aside  the 
tissue  and  the  glands  so  that  the  latter  follow  a  meridional, 
curved  course.  Over  the  top  of  the  ovum  the  edges  of  the  mu- 
cosa have  approached  each  other  in  an  attempt  to  close  the 
ovular  chamber  completely.  This  process  has  progressed  further 
in  mine  than  in  'Peters'  specimen.  In  both  cases  on  the  top  of 


THE  EMBEDDING  OF  THE  OVUM.  49 

the  arch,  where  the  ovum  has  entered,  a  blood  coagulum  is  found 
serving  as  a  protective  covering,  which  in  Peters'  specimen  re- 
sembles a  mushroom,  in  mine  a  caterpillar  with  a  large  head. 

This  variation  in  shape  so  well  pronounced  in  all  my  sections, 
calls  for  a  more  appropriate  name.  Peters'  term  "Gewebspilz" 
certainly  cannot  be  applied  to  my  specimen.  With  the  idea  that 
such  an  expression  should  be  applicable  to  all  later  cases  it 
seemed  most  natural  to  select  the  term  "fibrinous  cover"  (Fibrin 
decke).  Whatever  its  name  may  be,  however,  the  fact  remains 
that  in  these  two  youngest  human  ova  it  was  present,  large  and 
well  developed.  This  explains  the  peculiar  rests  of  fibrin  found 
on  the  top  of  the  ovum  in  older  specimens,  as,  e.  g.,  described  in 
my  atlas  (Uterus  und  Kind,  Plate  I). 

As  first  shown  by  Peters,  our  specimen  also  proves  that  the 
old  circumvallation  theory  of  the  formation  of  the  reflexa  is  in- 
correct, but  still  a  reflexa  is  present.  If  one  drops  a  stone  into 
the  water  the  latter  closes  over  it  and  if  an  earth  worm  bur- 
rows itself  into  the  ground,  the  hole  made  by  it  will  again  grad- 
ually be  filled  with  the  loosened  soil.  'The  rapidity  with  which 
it  becomes  closed  will  depend  upon  the  character  and  structure 
of  the  soil. 

It  seems  permissible  to  call  rcflc.va  in  Peters'  and  my  speci- 
men, those  decidual  arches  which  approach  each  other  approxi- 
mately over  the  center  of  the  ovum.  One  must,  however,  keep 
in  mind  that  these  arches  have  not  newly  formed  and  closed  over 
the  ovum,  but  that  as  a  matter  of  fact,  they  have  existed  from 
the  first  beginning  and  that  through  them  the  minute  ovule  has 
burrowed  its  way.  The  arches  become  higher  the  more  the 
ovum  grows.  It  is  obvious  that  the  opening  between  the  arches, 
i.  e.,  the  passageway  of  the  ovum,  finally  again  becomes  closed 
by  either  a  fibrinous  plug  or  a  fibrinous  band. 

In  the  following  it  will  be  shown  that  the  great  similarity  ex- 
isting between  the  microscopic  pictures  of  Peters'  and  my  speci- 
men, leads  to  a  like  interpretation  of  the  findings. 

Peters  (pg.  28)  emphasizes  that  his  ovum  has  become  im- 
planted in  the  swollen  mucosa  near  a  furrow,  the  same  has  oc- 
curred in  my  case.  Since  the  uterine  mucosa  prepared  to  receive 
the  ovum  is  traversed  by  numerous  deep  furrows,  he  thinks  it 
might  possibly  happen  "that  the  minute  human  ovule  could  be 
caught  in  such  a  groove  and  then  actually  could  become  em- 
bedded (exactly  like  the  ovum  of  the  erinaceus)  if  the  edges 
of  the  furrow  coalesced  and  finally  closed."  "In  such  an  in- 
stance, however,  the  ovum  would  be  completely  encircled  by  a 


50  THE  EMBEDDING  OF  THE  OVUM. 

uterine  epithelium  and  surely  one  or  the  other  gland  would  be 
found  opening  into  the  ovum." 

I  agree,  that  an  ovule  in  this  way  might  enter  such  a  furrow 
and  be  caught,  but  still  it  could  there  sink  into  the  mucosa,  but 
even  if  it  should  further  develop  while  wedged  in  this  groove, 
I  cannot  see  the  necessity  that  it  should  remain  surrounded  by 
uterine  epithelium  and  that  as  Peters  explains  this  protecting 
maternal  layer  should  then  be  secondarily  destroyed  by  the  pro- 
liferation of  the  fetal  trophoblast. 

In  the  premenstrual  stage  the  epithelium  of  the  uterine  mu- 
cosa is  loosened,  swollen  and  rendered  detachable  by  small  sub- 
epithelial  hemorrhages  to  such  an  extent  that  an  intact,  firmly 
adherent  and  continuous  epithelial  covering  in  such  a  furrow 
could  not  be  expected  and  hardly  ever  is  found.  Therefore, 
from  an  anatomic  histologic  point  of  view,  I  cannot  object 
against  the  possibility  of  ovular  implantation  in  a  furrow  and 
would  not  regard  it  as  surprising  if  a  gland  would  run  up  to  the 
ovular  chamber  (compare  Fig.  24  drt  Plate  XIV)  and  appar- 
ently open  into  it.  Such  facts  do  not  alter  my  present  assump- 
tion that  the  ovum  passing  through  the  superficial  epithelium  and 
pushing  the  glands  aside,  burrows  itself  into  the  mucosa. 

In  my  opinion,  it  matters  not  where  the  ovum  has  become 
attached  and  where  embedded,  whether  on  the  summit  of  a 
cotyledon  (as  in  'Peters'  case)  or  near  the  slope  of  an  elevation,  as 
in  my  specimen,  or  in  a  furrow,  the  ovule  will  everywhere  be 
the  source  of  considerable  irritation  and  a  pronounced  reaction  in 
the  adjoining  tissues.  This  reaction  has  been  so  well  described 
by  Peters  that  I  give  my  own  opinion  by  simply  citing  his  own 
words  (pg.  29)  :  "One  seems  justified  in  assuming  that  at  the 
site  of  implantation,  either  through  mechanical  irritation  or  by  a 
provision  of  nature,  the  tissues  become  highly  congested,  plasma 
(edema)  and  corpuscular  elements  of  the  blood  extravasate,  the 
preformed  endothelial  tubules  dilate,  the  mucosa  swells  and 
thickens.  It  still  remains  undecided  in  which  manner  the  blood 
elements  are  set  free,  whether  as  a  result  of  an  increased  pres- 
sure within  the  vessel  or  through  rhexis  or  a  free  diapedesis,  or 
possibly  the  capillary  vessels  have  been  opened  by  the  epiblast, 
which  has  begun  to  proliferate  as  soon  as  it  came  in  contact  with 
the  maternal  tissues.  The  fact  that  the  fibrinous  plug  which  lies 
on  the  summit  of  the  ovum  pointing  into  the  uterine  lumen,  con- 
sists of  blood  elements,  almost  forces  us  to  assume  that  during 
the  process  of  the  embedding  of  the  ovum  into  the  edematous 
connective  tissue  stroma,  the  ovum,  and  its  free  surface  towards 
the  uterine  cavity,  is  surmounted  by  a  blood  coagulum  which  pro- 


THE    EIANLAGE    AND    THE    OVULAR  CHAMBER  (EIKAMMER.)       51 

tects  it  and  possibly  furnishes  nutrition  for  that  portion  of  the 
ovular  surface  which  as  yet  has  not  established  its  connection 
with  the  maternal  tissue." 

If  we  compare  the  histologic  pictures  of  our  specimen- with 
this  description,  the  sections  15  to  19  call  for  special  attention, 
because  they  plainly  prove  the  minimal  but  quite  noticeable  es- 
cape of  blood  from  the  ovular  chamber  into  the  fibrinous  cover. 
We  have  also  seen  how  the  left  half  of  the  fibrinous  lid  has  be- 
come more  and  more  organized  and  in  this  way  reenforced  the 
decidual  envelope  and  how  to  the  right  the  large  head  of  the 
fibrinous  band,  which  lies  in  an  indentation  of  the  ovular  cham- 
ber, closes  the  opening  of  entrance. 

Still  other  similaraties  can  be  detected.  In  Peters'  ovum 
(Plate  III,  Fig.  4)  there  is  also  a  lateral  and  central  depression 
in  the  fibrin  plug,  so  that  the  fetal  ectoblast  almost  immediately 
touches  it.  On  the  other  hand  in  his  specimen  the  trophoblast 
processes  also  penetrate  into  the  decidual  layers  over  the  sum- 
mit of  the  ovum,  so  that  in  some  places  they  become  extremely 
thin  and  appear  worm  eaten. 

Finally,  it  shall  here  be  mentioned  (Peters,  pg.  44)  that  the 
envelope  of  the  embryo  of  Graf  v.  Spec  was  surmounted  by  a 
flat  blood  coagulum. 


III. 


THE     EIANLAGE     AND     THE     OVULAR     CHAMBER 
(EIKAMMER). 

\Vc  have  seen  that  the  o.vule  has  burrowed  itself,  gradually 
pushing  aside  the  decidual  tissue.  Some  of  the  glands  were  dis- 
solved, others  displaced.  The  blood  vessels  were  in  a  state  of 
^narked  congestion,  multiplication  and  coalescence.  This  shows 
clearly  how  the  ovular  chamber,  especially  its  summit,  consists 
<of  decidual  tissue  and  how  large  blood  spaces  adjoin  its  inner 
surface.  These  blood  spaces  are  divided  by  trophoblastic  col- 
umns and  communicate  directly  with  the  surrounding  capillaries 
situated  in  the  wall  of  the  ovular  chamber. 

In  the  next  chapter  these  intercommunicating  capillaries  and 
irophoblast  processes  with  their  attachment  to  the  inner  surface 
oi  the  ovular  envelope,  shall  be  considered. 

Here  we  shall  first  of  all  speak  in  general  of  the  "Eianlagev 
(Fig.  18,  Plate  X).  An  exact  idea  of  the  form  of  the  Eianlage 


52      THE    EIANLAGE    AND    THE    OVULAR   CHAMBER  (EIKAMMER.) 

could  be  gained  only  by  a  reproduction  of  pictures  of  all  consecu- 
tive sections,  which,  for  obvious  reasons  is  impossible. 

Studying  only  Fig.  18,  the  sections  60  to  70  and  80  and  81 
in  rir.te  XI,  Fig.  21,  one  gains  the  impression  that  a  somewhat 
irregularly  shaped  structure  lies  almost  in  the  center  of  the 
ovular  chamber  from  which  mesodermic  processes  extend  from 
all  sides.  Some  of  these  processes  are  covered  with  an  ectoder- 
mal  layer  (Fig.  18  ekt.). 

Here  and  there  the  ectoblast  layer  (e.  g.,  at  ek^)  is  detached 
by  an  extravasation  of  blood  under  it.  This  does  not  seem 
to  be  normal.  At  present,  however,  we  must  leave  the  ques- 
tion undecided  how  far  this  condition  is  pathologic  or  still  physio- 
logic in  this  earliest  stage  of  development.  The  number  of  very 
young  human  ova  so  far  known  to  us  is  still  too  limited,  on  the 
other  hand  in  our  case  the  ovule  and  the  entire  mucosa  of  the 
uterus  is  so  well  preserved  that  this  one  feature,  even  if  patho- 
logic, could  not  diminish  the  value  of  the  other  fiindings. 

Considering  the  form  of  the  Eianlage  as  it  appears  in  our  own 
specimen,  we  find  in  a  series  of  consecutive  sections  that  it  is  at- 
tached with  a  broad  base  to  the  inner  wall  of  the  ovular  cham- 
ber near  its  summit  (Fig.  18  a).  This  attachment  is  firm  and 
the  tissue  is  here  also  slightly  permeated  with  red  blood  cells.  If 
permitted  to  make  a  comparison  one  could  say  that  the  ovule 
sticks  like  a  leech  with  its  head  to  the  inner  wall  of -the  ovular 
envelope,  while  the  rest  of  the  body  is  suspended  in  the  cavity. 
In  order,  however,  to  avoid  any  misunderstanding  it  is  here 
stated  that  already  in  this  stage  long  trophoblastic  processes  ex- 
tend from  the  irregularly  shaped  Eianlage  (Fig.  18,  tr,  tr,  Plate 
X)  which  are  attached  to  the  chamber  wall,  and  in  this  way,  like 
thin  threads,  fasten  the  apparently  floating  ovum. 

Even  under  very  high  magnification  this  Eianlage  is  appar- 
ently composed  only  of  a  congealed  mass,  traversed  here  and  there 
by  structureless,  very  delicate  fibres,  the  latter  passing  chiefly 
along  the  sinuous  periphery  of  the  Eianlage.  The  actual  contour, 
however,  in  the  main  is  formed  by  small  round  or  oblong  cells 
with  deeply  stained  nuclei  which  in  connection  with  the  trans- 
parent network  of  fibres  create  the  picture  of  villous  tissue,  i.  e.. 
of  the  "Anlage"  of  the  mesoderm. 


Before  entering  into  a  consideration  of  the  trophoblast  and  its 
attachment,  it  may  be  well  to  recapitulate  what  has  been  said 
before.  It  seems  important '  to  have  a  clear  conception  of  the 
condition  of  the  ovum  after  it  has  entered  the  mucosa  and  of 


THE    EIAXLAGE    AND    THE    OVULAR  CHAMBER  (EIKAMMER.)      53 

the  condition  of  the  endometrium  at  the  time  when  the  ovum  is 
entering  it.  We  assume  that  the  most  suitable  time  for  implan- 
tation of  the  fertilized  ovum  is  the  last  few  days  preceding  the 
first  missed  menstruation. 

In  the  premenstrual  stage  the  mucosa  is  not  only  congested, 
but  as  is  shown  in  Fig.  25,  Plate  XV,  permeated  by  extra vasated 
blood.  According  to  Gebhard,  a  second  stage  follows  character- 
ized by  an  accumulation  of  large  extravasates  in  irregular  lacunae 
of  the  mucosa.  As  a  result  of  the  rupture  of  some  capillaries 
beneath  the  surface  epithelium,  subepithelial  haematomata  are 
formed  from  which,  after  slight  detachment  of  the  epithelium, 
blood  escapes  into  the  uterine  cavity  as  -the  visible  menstrual 
flow. 

The  blood  which  has  escaped  from  the  capillaries  thus  spreads 
both  beneath  the  epithelium  and  in  the  deeper  layer  of  the  mu- 
cosa as  an  irregular  extravasate  and  also  enters  the  glands  (Geb- 
hard). One  must  therefore  bear  in  mind  that  this  free  blood  lies 
chiefly  in  artificial  cavities,  not  lined  by  an  endothelium. 

The  fertilized  ovum  which  in  the  premenstrual  stage,  i.  e., 'be- 
fore the  menstrual  flow  has  appeared,  is  about  to  enter  the  uter- 
ine mucosa,  finds  a  markedly  loosened  tissue  infiltrated  with  blood 
and  will  hardly  experience  any  difficulty  to  pass  through  or  push 
aside  the  loosened  surface  epithelium. 

When  the  ovum  has  penetrated  the  superficial  layers  of  the  en- 
dometrium it  is  in  a  tissue  permeated  by  the  extravasates  just 
described  and  lies  either  free  in  one  of  these  extravasates  or  at 
least  at  the  edge  of  one  of  them  in  the  tissue  of  the  mucosa.  At 
any  rate,  we  seem  justified  in  assuming,  that  the  fertilized  ovum, 
immediately  after  its  implantation,  displays  great  vitality,  that  it 
will  develop  and  that  above  all  things  it  will  attempt  to  fasten 
itself,  which  probably  is  most  quickly  accomplished  by  extending 
the  first  trophoblast  processes. 

My  idea  is,  that  the  embedded  ovum,  for  a  very  short  time, 
either  partly  or  completely,  lies  in  a  blood  extravasate.  Since 
these  blood  spaces  have  formed  as  a  result  of  a  rupture  of  capil- 
laries they  are  devoid  of  a  continuous  endothelial  lining  and 
show  an  endothelium  only  at  places  where  ruptured  capillaries 
enter. 

The  ovum  thus  floats,  possibly  only  for  the  first  few  hours,  in 
a  blood  cavity,  i.  e.,  it  is  from  the  very  beginning  surrounded 
by  a  maternal  blood  from  which  it  receives  its  nutriment.  When 
and  how  quickly  the  entrance  gate  is  closed  again  we  do  not 
know,  it  is  possible  that  this,  process  varies  as  to  mode  and  time. 
Many  observations,  however,  suggest  that  the  closure  is  effected 


54       THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES. 

by  means  of  a  drop  of  blood  which  coagulates  and  later  becomes 
organized.      (Peters,  Leopold,  Graf  v.  Spec.) 

That  it  should  be  closed  by  a  blood  drop  is  not  at  all  surpris- 
ing, since  the  ovum  breaking  into  the  mucosa,  so  to  say,  has  set 
a  small  wound  and  has  opened  up  a  blood  cavity.  From  the  lat- 
ter a  small  amount  of  blood  could  easily  ooze.  This,  then,  would 
at  the  same  time  be  the  most  natural  process  o*f  restoration  of 
the  injury  produced  by  the  process  of  embedding. 


Without  these  preliminary  remarks  it  would  be  rather  difficult 
to  understand  the  following  chapter  dealing  with  the  trophoblast. 

In  studying  the  trophoblast  I  had  the  same  experience  as 
Peters.  The  microscopic  pictures  are  so  varied  and  oftentimes 
so  complex  that  it  requires  considerable  time  to  properly  interpret 
the  findings.  One  often  wonders  what  bold  conclusions  were 
drawn  by  onesself  and  other  writers,  concerning  the  very  early 
stages  of  development,  from  the  study  of  ova  representing  a 
much  later  period  of  pregnancy. 

It  is  obvious  that  it  should  be  the  aim  of  both  gynecologist  and 
pathologic  anatomist  to  search  for  all  available  material  in  order 
to  place  our  knowledge,  concerning  the  first  days  of  embryonic 
life,  upon  a  more  secure  basis. 

After  having  followed  the  ovule  up  to  its  entrance  into  that 
irregular  blood  space  of  the  mucosa,  it  becomes  interesting  to 
understand  the  action  and  functions  of  the  ovum  for  the  pur- 
pose of  sustaining  its  existence.  This  is  accomplished  chiefly 
by  means  of  the  trophoblast. 


IV. 


THE  TROPHOBLAST  AND  ITS  SURROUNDING  BLOOD 
SPACES.     THE  INTERVILLOUS   CIRCULATION. 

In  presenting  this  subject  the  following  order  seems  the  most 
appropriate :  With  the  aid  of  sections  50  to  100  taken  from  the 
center  of  the  ovum  we  elucidate :  1.  THE  BOUNDARIES  OF 
THE  EIANLAGE  AND  THE  TRO'PHOBLASTIC  PRO- 
CESSES. 2.  THE  MANNER  BY  WHICH  THESE  TROPH- 
OBLASTIC  PLUGS  BECOME  FASTENED  TO  THE  IN- 
NER  WALL  OF  THE  OVULAR  CHAMBER.  3.  THE 
BLOOD  SPACES  LYING  BETWEEN  THE  TROPHO- 
BLASTIC  PROCESSES.  4.  THE  RELATION  OF  THESE 


THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES.       55 

BLOOD  SPACES  TO  THE  CONFLUENT  CAPILLARIES 
IN  THE  SURROUNDING  TISSUE. 

ad.  1.  In  Figs.  16,  17  &  18  (Plates  IX  &  X),  the  ectoblast 
cover  and  the  trophoblast  processes  are  seen.  We  are  able  to 
follow  both  their  primary  condition  and  further  development. 

The  ectoblast  (in  Fig.  18  ekt.  and  Ek^.  Figs.  16  &  17  ekt. 
and  Figs.  26  &  27  Plate  XVI)  consists  of  a  double  row  of  cells. 
The  inner  row  is  composed  of  round,  in  some  places  oval  cells 
adjoining  each  other  with  their  pole  ends  and  containing  a  dark 
stained  nucleus  which  almost  fills  the  cell.  (Langhans'  cells  Figs. 
26  &  27  1.  z.).  On  the  outside  of  this  cell  layer  we  find  much 
larger  cells  which  contain  one  or  more  nuclei.  Many  of  these 
cells  are  considerably  swollen,  showing  a  fine  granulation  of  their 
cellular  substance  (Syncytiurh).  (Figs.  26  &  27  sy.)  In  fol- 
lowing this  ectoblastic  band,  which  here  and  there  is  detached 
from  the  mesoblast,  in  the  sections  47  and  60  represented  in  Figs. 

16  &  17,  we  can  establish  several  facts.    At  various  places  (e.  g., 
Fig.   17  k)   by  a  proliferation  of  the  Langhans'  cells  the  inner 
layer  is  thickened,  forming  small  buds  covered  by  the  syncytium. 
These  buds  gradually  become  thicker  and  longer    (Figs.   16  & 

17  tr  &  Fig.  18  tr  to  the  right),  but  almost  everywhere  remain 
covered  with  syncytial  cells,  as  can  be  recognized  in  Figs.  16  & 
17  under  high  magnification   from  the     double     layered     band 
marked  "ekt."     (Fig.  27  sy.) 

The  ectoblast  in  this  stage  of  delevopment  has  already  sent 
out  a  number  of  short  sprouts,  but  the  mesoderm  which  is  just 
forming  has  not  as  yet  entered  these  processes,  so  that  one  can- 
not speak  of  villi  in  the  usual  meaning  of  this  term. 

It  must,  however,  be  emphasized  that  these  earliest  buds  as 
well  as  the  further  developed  processes  (the  ectoblastic  band  in 
Fig.  16)  are  completely  surrounded  by  maternal  blood  and  do  not 
come  in  contact  nor  have  any  connection  with  the  maternal  tis- 
sue, especially  decidual  cells. 

While  this  fact  alone  proves  the  close  relationship  of  these  two 
cell  layers  to  the  ectoblast,  furthermore,  in  this  stage  of  devel- 
opment of  the  ovum  absolutely  nothing  speaks  in  favor  of  an  as- 
sumption that  the  ectoblast  or  possibly  its  external  cover  the 
syncytium,  etiologically  has  any  relation  to  the  maternal  tissue. 
The  ectoblast  is  a  part  of  the  Eianlage,  its  buds  are  the  expres- 
sion of  the  development  of  the  latter.  Without  an  Eianlage  neith- 
er a  formation  of  trophoblast  nor  a  proliferation  of  syncytium  is 
conceivable. 

Following  further  the  increase  in  the  size  of  the  trophoblastic 
buds  (e.  g.,  Fig.  18  tr.  to  the  left;  Fig.  16  tr  to  the  left;  Fig.  21 


56   THE  TROPHOBLAST  AND  ITS  SURROUNDING  BLOOD  SPACES. 

Plate  XI;  Fig.  22  tr,  tr;  Fig.  23  tr  Plate  XII  &  XIII)  one  no- 
tices that  the  Eianlage,  besides  these  finest  processes,  gradually 
sends  forth  larger  ones  which  tend  to  reach  the  inner  surface 
of  the  ovular  chamber.  Peters  has  very  appropriately  (pg.  91) 
compared  these  trophoblastic  processes  to  the  arms  of  an  oc- 
topus. 

Here  also  nothing  can  as  yet  be  seen  of  an  extension  of  the 
mesoderm  into  these  trophoblastic  buds.  It  seems  that  first  of 
all  the  ovum  attempts  to  gain  a  firm  hold  and  only  later  it  pro- 
ceeds to  form  true  villi  by  the  proliferation  of  the  mesoderm. 

ad.  2.  How  and  where  do  the  ends  of  the  trophoblastic  pro- 
cesses become  attached  to  the  wall  of  the  ovular  chamber? 

In  order  to  answer  this  question  we  must  study  not  only  the 
sections  through  the  middle,  but  especially  those  through  the 
lateral  portion  of  the  ovum.  (100  to  120.)  A  very  notable 
finding  can  be  recorded.  In  speaking  of  the  Eianlage  it  has 
been  stated  that  it  is  attached  like  a  leech  with  a  broad  head  to  the 
summit  of  the  ovular  envelope,  but  that  here  also  the  attachment 
is  effected  by  a  thin  layer  of  ectoblast  containing  syncytial  cells. 

In  looking  over  the  sections  through  the  lateral  portion  of  the 
ovum  one  notices  that  coincident  with  the  gradual  disappearance 
of  the  Eianlage,  broad  trophoblastic  processes  and  columns  along 
the  whole  periphery  of  the  ovum  but  especially  near  its  sum- 
mit, like  a  network,  connect  the  Eianlage  with  the  chamber  walls. 

The  processes  and  columns  consist  of  oval  Langhans'  cells 
darkly  stained,  closely  pressed  together  and  filled  with  round  and 
oblong  nuclei.  Everywhere,  especially  so  laterally,  they  are 
covered  with  large  syncytial  cells,  some  of  them  oblong  irregu- 
larly shaped,  others  standing  on  their  edge  filled  with  oblong 
crescent  shaped  or  with  small  nuclei  tightly  pressed  together. 

The  ends  of  these  processes  with  their  syncytial  cover  have 
penetrated  deeply  into  the  thin  layer  of  tissue  over  the  summit  of 
the  ovum  (Figs.  16  &  17  sy.  Plate  IX).  Here,  where  the 
covering  fibrinous  band  has  almost  disappeared,  we  meet  with 
conglomerations  of  syncytial  cells.  Lying  close  together  they 
almost  create  the  impression  of  rests  of  surface  epithelium  (Figst 
12  &  13  sy.  Plate  VII)  ;  yet  their  connection  with  syncytial  cells 
emerging  from  deeper  layers  is  so  evident  that  any  idea  of  their 
relation  to  rests  of  epithelium  must  be  repudiated.  There  is  still 
another  fact  which  prohibits  such  an  assumption.  It  has  been 
mentioned  several  times  that  from  the  surface  of  the  mucosa  a 
narrow,  irregular  band  resembling  degenerated  epithelium  creeps 
over  the  edge  of  the  fibrinous  cover.  In  these  sections  also,  in 
which  the  fibrinous  cover  is  still  missing,  appearing  only  in  later 


THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES.        57 

sections,  this  band,  although  somewhat  uneven,  again  appears. 
Since  here  and  there  distinct  cuboidal  epithelial  cells  are  visible, 
one  seems  justified  in  pronouncing  it  surface  epithelium,  it  then 
would  be  a  swollen  rest  which  has  remained  between  the  two 
coagulated  blood  droplets  lying  on  the  summit  of  the  ovum.  For 
this  reason  there  can  be  no  association  between  the  epithelial  like 
rows  of  syncytium  and  the  surface  epithelium.  (Compare 
Peters'  Plate  V  Figs.  10  to  13,  the  epithelial  like  arrangement  of 
syncytial  cells.) 

From  this  explanation  one  can  understand  how  in  Figs.  11  & 
13  (Plate  VII)  syncytial  cells  arising  from  trophoblast  (tr) 
have  become  arranged  in  rows  and  finally  terminate  in  a  large 
cluster  of  cells,  (sy.) 

The  same  holds  true  as  mentioned  before  for  the  syncytial  pro- 
cess (sy.)  in  Fig.  10  (Plate  VI),  which  originates  from  the 
trophoblast. 

In  rather  regular  intervals  but  forming  quite  irregular  arches 
the  trophoblast  processes  which  at  first  have  floated  more  or  less 
freely  in  the  maternal  blood  spaces,  approach  the  inner  surface  of 
the  ovular  chamber  (Fig.  6  tr.  Plate  III)  and  by  means  of 
these  arches  subdivide  the  periphery  of  the  chamber  into  smaller 
blood  lacunae.  (Fig.  15  tr;  Figs.  22  &  23  tr.)  Thus  these 
lacunae  develop  within  the  trophoblastic  shell  of  the  ovum  as  is 
so  excellently  shown  in  'Plate  I  of  Peters'  work. 

Since  the  trophoblast  excrescences  and  processes,  as  mentioned 
above,  are  covered  with  a  syncytium,  it  becomes  obvious  that 
these  blood  lacunae  are  lined  with  a  syncytial  layer  which  is 
plainly  visible  everywhere  on  the  concave  side  of  the  arches. 
(Fig.  23  sy.)  In  this  manner  the  syncytium  forms  a  line  of 
demarcation  between  the  trophoblastic  framework  and  the  blood 
lacunae. 

In  comparing  these  blood  lacunae  in  the  periphery  of  the  ovum 
one  notices  at  once  a  difference  among  them  which  one  really 
must  expect  and  which  also  is  noticeable  in  Plate  I  of  Peters' 
work.  The  lacunae  lying  near  the  summit  are  more  or  less 
closed,  while  those  situated  in  the  depth  and  on  both  sides  are, 
by  means  of  narrow  channels,  connected  with  the  large  blood 
spaces  in  the  decidua.  This  difference  explains  itself  in  the  fol- 
lowing manner:  In  the  lacunae  near  the  summit  (Fig.  6  tr),  the 
closure  of  the  arches  is  effected  by  the  thin  wall  of  reflexa  or  by 
the  fibrin  cover,  while  this  is  impossible  in  the  remaining  portion 
of  the  periphery.  Here  the  vessel  walls  are  opened  as  a  result  of 
their  rupture.  (Fig.  6,  c.) 

Whether   the   lacunae   appear  more   closed    or   open,    in   both 


58      THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES. 

cases  the  manner  in  which  the  ends  of  the  trophoblast  processes 
become  fixed  to  them  is  the  same.  It  is  effected  by  means  of 
smaller  and  larger  single  syncytial  cells,  at  times  by  groups  of 
them  which  glue  these  processes  to  the  decidual  tissue. 

How  intimate  this  attachment  may  become  which,  especially 
in  the  tissue  of  the  summit  of  the  ovum,  could  be  called  an  an- 
choring, can  be  seen  in  Fig.  11  (Plate  VII).  Here  the  tropho- 
blast, together  with  its  adjoining  syncytial  cells,  has  buried  itself 
deeply  into  the  decidual  coat  and  advanced  to  "sy"  with  one  large 
giant  cell.  A  similar  condition  can  be  observed  in  Fig.  11  at  tr 
and  tr1}  where  the  syncytial  cells  radiate  from  the  trophoblastic 
processes  in  various  directions. 

In  the  periphery  of  the  ovum  the  connecting  syncytial  cells  at- 
tach themselves  to  the  nearest  decidual  trabeculae  or  to  the  re- 
maining portions  of  the  walls  of  the  enormously  dilated  and  rup- 
tured capillaries  and  blood  vessels.  Hereby  a  connection  of  the 
latter  with  the  blood  lacunae  is  established  and  maintained. 

The  syncytium  therefore  does  not  only  serve  the  important 
purpose  of  fastening  and  anchoring  the  trophoblast,  but  during 
the  further  development  of  the  ovum  brings  about  the  gradual 
dissolution  of  more  capillary  walls  (Fig.  28  Plate  XVI)  and  in 
this  manner  constantly  provides  larger  and  larger  blood  spaces 
for  the  sustenance  of  the  ovum. 

Now  that  we  have  become  acquainted  with  blood  spaces  which 
lie  between  the  trophoblastic  processes  (ad.  3),  it  will  be  neces- 
sary to  explain  (ad.  4)  the  relation  of  these  blood  spaces  to  the 
confluent  capillaries  in  the  surrounding  decidual  tissue.  For  this 
purpose  sections  81  to  96  and  also  Figs.  22  &  23  (Plates  XII  & 
XIII)  must  be  studied. 

In  looking  over  these  sections  one  must  keep  in  mind  the 
fact  that  the  ovum  has  entered  a  tissue  which  as  a  result  of  the 
premenstrual  state  was  highly  congested.  Blood  vessels  as  well 
as  glands  were  greatly  dilated.  Blood  extravasated  from  the  cap- 
illaries, passed  into  the  interstitial  tissue  and  finally  also  found 
its  way  into  the  glands.  Thus  the  Kianlage  was  surrounded  and 
the  ovular  chamber  formed  by  a  very  loose  and  spongy  tissue 
infiltrated  with  blood  consisting  in  the  main  of  dilated  capil- 
laries, many  of  them  ruptured. 

No  matter  how  many  specimens  we  examine  and  compare,  the 
same  condition  will  be  noticed  in  all.  The  inner  wall  of  the 
ovular  chamber,  as  already  mentioned,  is  formed  partly  by  di- 
lated capillaries  and  partly  by  open  blood  spaces  with  their  inter- 
vening framework.  Since  the  open  blood  spaces  only  recently 
have  been  closed  capillaries,  their  inner  wall,  not  everywhere  but 


THE   TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES.        59 

almost  throughout,  is  lined  with  an  enclothelium.  In  the  im- 
mediate neighborhood  of  the  blood  lacunae,  in  the  loose  tissue, 
numerous  large  syncytial  cells  are  found  singly  or  in  clusters, 
some  of  them  lying  close  to  the  chamber  wall.  These  cells,  so  to 
say,  are  the  pathfinders  for  the  syncytimn,  which  glues  the 
trophoblastic  processes  to  the  wall.  For  this  reason  a  great  num- 
ber of  large  syncytial  cells  are  met  with  in  the  sections  which 
pass  far  laterally  through  the  ovum.  (Fig.  4  sy.  Plate  II.) 

It  is  noteworthy  that  wherever  a  syncytial  cell  lies  close  to 
a  vessel  wall  the  corresponding  endothelial  cell  on  the  inside,  in 
comparison  to  others,  seems  enlarged  and  contains  a  very  large 
nucleus  which  either  is  oblong  or  undergoing  segmentation. 

One  could  feel  inclined  to  think  that  the  transformation  of  the 
endothelium  into  syncytium  is  the  primary  result  and  that  the 
syncytium  develops  further  from  here.  One  then  could  con- 
clude that  the  syncytium  in  the  main  originates  from  vessel  en- 
dothelium. In  our  specimen,  however,  no  support  whatever  can 
be  detected  for  such  an  assumption.  As  a  matter  of  fact,  the 
conditions  are  as  follows :  The  syncytial  cells  which  cover  the 
trophoblastic  processes  and  attach  themselves  to  the  walls  enter 
the  tissue,  become  disseminated  between  the  capillaries  and 
glands  especially  in  the  remaining  framework  of  tissue.  They 
attach  themselves  to  the  walls  of  the  capillaries  which  are  still 
closed,  corrode  them  and  thus  constantly  open  new  blood 
spaces.1 

This  process,  e.  g.,  is  represented  in  the  sections  86  to  89.  Here 
we  see  large  rows  of  syncytial  cells  which  advance  from  a 
trophoblast  process  towards  the  wall  of  a  transversely  cut  cap- 
illary and  attach  themselves  to  cells  of  the  wall.  (Fig.  28  sy. 
Plate  XVI.)  In  the  next  section  syncytial  cells  pass  into  a  ves- 
sel wall.  Its  various  layers  become  detached  from  each  other. 
The  tissue  cells  which  formerly  lay  in  closed  arches  as  well  as 
the  endothelial  cells  are  now  unraveled.  In  the  next  sections  we 
see  blood  cells  oozing  from  these  unraveled  vessel  walls.  The 
syncytial  cells  force  their  way  deeper  and  deeper  into  the  lumen. 
Finally  one  sees  only  half  of  the  wall  of  the  vessel  until  this,  too, 
is  dissolved.  In  this  way  the  peripheral  blood  spaces,  one  after 
the  other,  are  destroyed  by  the  never  ceasing  action  of  the  syn- 
cytial cells  and  from  these  findings  the  conclusion  must  be  drawn 
that  already,  /.  c.,  even  in  this  early  stage  of  development,  the 
intervillous  spaces  are  indicated  and  even  existing. 


1  At  the  Congress  in  Kiel,  Peters  demonstrated  drawings  which  show  beautifully  how 
endothelial  cells  become  detached  and  necrotic  exactly  at  those  places  where  syncytial 
cells  have  attached  themselves  to  the  outside  of  capillaries;  another  proof  that  endothelial 
cells  do  not  transform  into  syncvtium. 


60       THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES. 

Correctly  we  cannot  as  yet  speak  of  intervillous  spaces  be- 
cause the  mesoderm  has  not  yet  entered  trophoblastic  process  so 
that  villi  in  the  strict  sense  of  the  word  do  not  exist.  In  Peters' 
specimen  (Plate  II)  they  have  already  formed.  Therefore,  it 
would  be  more  appropriate  in  our  ovum  to  apply  to  these  blood 
spaces  the  term  "intertrophoblastic." 

It  seems,  however,  not  desirable  to  add  new  difficulties  by  in- 
troducing a  new  term.  The  reader  acquainted  with  the  subject 
will  know  what  is  meant  and  it  would  seem  permissible  to  speak 
of  an  "Anlage  of  intervillous  spaces"  even  in  this  stage,  since 
very  soon  villi  actually  will  enter  these  trophoblastic  excres- 
cences. 


What  can  be  attributed  to  the  findings? 

I  am  well  aware  of  the  fact,  that  although  it  lies  completely  in 
situ  and  has  been  carefully  handled,  still  it  shows  in  a  few  sec- 
tions, an  excessive  amount  of  blood  which,  here  and  there,  has 
pressed  the  Eianlage  together  and  detached  the  ectoblast.  Ow- 
ing to  this  I  hesitated  in  publishing  my  findings,  but  since  in  the 
main  all  those  conditions  which  I  wish  to  demonstrate  were  so 
plainly  visible,  and  so  instructive,  I  was  finally  persuaded  to  do 
so  by  'Prof.  Graf  v.  Spec. 

I  believe  that  the  description  of  my  ovum  is  of  value  so  long  as 
no  other  ovum  of  the  same  age  or  possibly  a  younger  one  still 
better  preserved  is  known.  I  will  therefore  compare  my  find- 
ings with  those  made  on  the  youngest  ovum  known  in  literature. 

Peters  has  extensively  quoted  all  those  writers  who  have  de- 
scribed older  ova  and  carefully  compared  his  findings.  Thus  I 
am  justified  in  limiting  myself  here  to  his  description  and  his 
critical  review  of  the  literature  on  the  subject,  and  shall  empha- 
size only  points  of  importance  in  these  new  findings.  For  a  con- 
sideration of  this  subject,  only  a  few  of  the  recent  contributions 
will  be  considered,  and  this  will  also  appiy  to  the  following  chap- 
ter dealing  with  the  syncytium :  Pfannenstiel  in  Winckels  Hand- 
buch  der  Geburtshilfe,  Rossi  Doria,1  Marchand,2  Friolet,3  Herr- 
mann and  Stolper,4  Webster,5  Graf  v.  Spec  and  Beneke  1.  c. 

Peters'  description  of  the  trophoblast  corresponds  in  all  es- 
sential features  with  ours.  He  found  the  development,  the 


1  Ueber  die  Einbettung  des  menschlichen  Fies.  studiert  an  einem  kleinen  Ei  der  zweiten 
Woche.     Arch.  f.  Gynaekologie  76. 

2  Beobachtungen  an  jungen  menschlichen  Eiern.     Anat.  Hefte.     21.  B. 

3  Beitrag  zum  Studium  der  menschlichen  Placentation.     Leipzig,  Thieme.      1904. 

4  Zur  Syncytiogenese  beim  Meerschweinehen.     Wien,   Hoelder.      1905. 

5  Die  Placentation  beim  Menschen.     Uebers.  von  Kolischer.     Berlin,  O.  Coblenz,  1906. 


THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES.        61 

structure  and  the  lining  of  the  trophoblast  processes  with  syn- 
cytium  exactly  the  same  as  I  saw  them.  He  says  on  page  49: 
"From  the  simple  cuboidal  cells  of  the  central  portion  of  the 
trophoblast  one  can  successively  follow,  towards  the  surface,  their 
transition  into  the  large  syncytial  formations/' 

"Those  blood  lacunae  which  on  their  proximal  surface  carry  a 
layer  of  ectoblast  cells,  are  almost  completely  lined  by  a  thin 
layer  of  protoplasm  in  which  cell  membranes  not  discernible  and 
in  which  nuclei  are  visible,  arranged  in  rows.  In  transverse  sec- 
tions these  nuclei  appear  spindle  shaped,  in  oblique  and  longi- 
tudinal sections  they  look  flat,  often  irregularly  bent  and  in  their 
appearance  seem  identical  with  the  nuclei  previously  described 
in  the  peripheral  layer  of  the  ectoblast.  This  thin  protoplasma 
coat  which  in  the  central  portion  of  the  blood  lacunae  resembles 
a  layer  of  epithelium,  continues  on  the  lateral  walls  of  the  lacunae, 
thus  enclosing  the  trophoblast  columns." 

Peters  therefore  also  finds  the  blood  within  the  lacunae  sep- 
arated from  the  trophoblastic  excrescences  and  columns,  espe- 
cially within  the  arches,  by  a  syncytial  lining. 

As  far  as  that  area  of  the  decidua  compacta  is  concerned, 
which  immediately  adjoins  the  trophoblast  (Umlagerungszone 
of  Peters  pg.  52),  here  surrounding  the  entire  ovum,  especially 
on  the  side  of  the  serotina,  greatly  dilated  maternal  blood  vessels 
and  a  large  number  of  transverse  sections  through  glands  are 
seen,.  The  uterine  mucosa  here  is  not  only  edematous,  but  also 
abundantly  infiltrated  with  blood  elements. 

Further  away  from  the  ovum  in  Peters'  specimen  (Plate  I)  a 
large  endothelial  tube  is  visible  from  which  a  number  of  larger 
and  smaller  vessels  branch  off.  These  encircle  the  ovum  like 
meridians  the  globe.  "They  communicate  with  the  blood  lacunae 
of  the  trophoblast  near  the  oyular  pole,  often  only  after  having 
first  passed  through  a  part  of  the  'Umlagerungszone'  or  through 
intermediate  layers  lying  between  it  and.  the  compacta.  In  other 
places  these  vessels  after  only  a  short  course  open  into  the  la- 
cunae at  points  near  the  serotina." 

As  regards  the  relation  of  the  trophoblast  to  the  surrounding 
capillaries  and  their  endothelial  tubes,  Peters'  investigations  (pg. 
59)  show  that  the  trophoblastic  processes  do  not  bore  their  way 
into  the  endothelial  walls  as  I  have  described,  but  that  the  blood 
has  actively  broken  into  the  trophoblast.  This  condition  Peters 
has  depicted  in  that  excellent  illustration,  Fig.  23,  vPlate  A,  to 
which  I  cannot  furnish  an  equal  from  any  one  of  my  sections. 
I  have  only  been  able  to  observe,  as  stated  above,  that  at  first  the 
ovule  lies  in  a  premenstrual  extravasate  of  blood  in  the  mucosa, 


62   THE  TROPHOBLAST  AND  ITS  SURROUNDING  BLOOD  SPACES. 

that  next  the  trophoblast  grows,  by  means  of  syncytial  cells, 
which  it  sends  out  into  the  surrounding  tissue,  corrodes  the  next 
capillary  and  thus  brings  one  capillary  after  the  other  in  com- 
munication with  the  blood  lacunae.  Since  the  great  vascularity, 
however,  in  the  neighborhood  of  my  ovum  possibly  is  abnormal, 
I  am  willing  to  admit  that  most  probably  Peters'  histologic  find- 
ings are  more  correct  and  therefore  his  deductions  more  reliable. 
It  must  be  added,  however,  that  this  difference  in  the  findings  is 
of  little  importance,  since  I  could  show  exactly  like  Peters — a 
point  of  much  greater  importance — that  a  communication  exists 
between  the  blood  spaces  within  the  trophoblastic  arches  and 
those  lying  farther  away.  We  established  in  this  way  the  fact, 
that  at  this  early  time  intervillous  blood  spaces  exist  in  a  rudi- 
mentary and  fully  developed  state. 

Mention  must  be  made  of  a  rather  important  finding  by  Peters 
on  an  ovum  3x5  mm.  large  (i.  e.,  much  larger  than  my  ovum), 
obtained  from  a  woman  who  died  of  phosphorus  poisoning. 
"With  due  regard  to  the  fact  that  this  was  a  case  of  phosphorus 
poisoning  he  states  that  in  this  ovum  in  which  the  trophoblast 
layer  was  already  reduced  to  the  double  layered  chorion  epithelium 
(Langhans'  cells  plus  syncytium)  and  which  with  its  villi  was 
embedded  in  a  lake  of  blood,  the  intervillous  space  by  means  of 
a  continuous  layer  of  fibrin  which  completely  surrounded  the 
ovum,  was  separated  from  the  compacta,  pathologically  changed 
by  a  suffusion  of  blood.  Whether  this  fibrin  layer  by  compari- 
son with  undoubtedly  normal  specimens  can  be  regarded  as  the 
primary  stage  of  the  fibrin  layer  of  Nitabuch  is  a  question  which 
cannot  be  answered." 

I  must  mention  that  also,  in  my  ovum,  in  some  sections,  espe- 
cially near  the  border  of  the  greatly  dilated  and  open  blood  spaces 
which  surround  the  ovum  like  a  shell,  such  strips  of  fibrin  are 
visible.  I  should  like  to  refrain,  however,  from  positively  defin- 
ing their  significance. 

The  following  points  which  have  been  clearly  established  by 
the  descriptions  given  above  must  be  emphasized :  The  formation 
of  the  blood  lucanae  in  the  trophoblast  does  not  stand  in  any  di- 
rect relation  to  the  destruction  and  dissolution  of  the  glands,  a 
point  which  also  has  been  made  by  Peters,  (pgs.  75  &  76). 
Nowhere  is  syncytium  formed  from  glandular  epithelium. 

I  cannot  agree  with  Pfannenstiel,  who,  also  in  all  essential 
points  in  accord  with  Peters,  holds  different  views  in  certain 
questions,  e.  g.,  concerning  the  mucosa  surrounding  the  ovum. 
His  observations  are  made  on  a  comparatively  too  old  an  ovum, 
being  almost  two  weeks  old.  He  asserts  (pg.  242)  that  in  his 


THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPAOES.        63 

belief  the  blood  lacunae  in  the  trophoblast  are  new  formed  cap- 
illaries of  the  decidua,  whose  walls — either  the  endothelium  or 
the  surrounding  connective  tissue — had  transformed  into  syncy- 
tium.  In  none  of  my  sections  could  I  find  any  support  of  this 
view. 

Like  Peters,  I  found  that  the  partitioned  lacunae  at  the  bor- 
der, for  the  very  reason  that  they  are  lying  between  the  tropho- 
blast columns  and  in  fact  are  formed  by  them,  are  lined  with  a 
layer  of  syncytium  which  ceases  where  the  ends  of  the  tropho- 
blastic  processes  peripherally  reach  either  the  framework  of  the 
mucosa  or  the  walls  of  the  open  blood  vessels.  It  seems  ques- 
tionable to  me  whether  these  lacunae,  although  of  maternal  or- 
igin, can  be  called  new  formed  capillaries  of  the  decidua.  This  is, 
however,  a  point  of  minor  consequence.  Of  much  more  import- 
ance is  the  fact,  that  the  syncytial  coat  of  these  lacunae,  as  has 
been  demonstrated  above,  derives  its  existence  from  the  Eianlage, 
i.  e.,  from  the  ectoblast. 

Most  noteworthy  findings  have  been  made  by  Rossi  Doria,  who 
examined  an  ovum  dating  from  the  beginning  of  the  second  week 
of  pregnancy.  Aside  from  many  observations  which  are  fully 
in  accord  with  those  made  by  Peters  and  myself,  his  findings  con- 
cerning the  trophoblastic  capsule  are  especially  interesting. 

He  also  claims  that  the  fertilized  ovum  penetrates  the  ex- 
tremely congested  mucosa  of  the  premenstrual  stage  and  enters 
a  space  filled  with  extravasated  blood.  "The  chorionic  tropho- 
blast excrescences  from  the  ectoderm  proliferate  through  the 
blood  until  they  reach  the  surrounding  connective  tissue.  They 
spread  out  with  it  and  cause  certain  changes."  These  consist  in  a 
dilation  and  rupture  of  capillaries  and  in  the  formation  of  new 
extravasates  in  which  the  trophoblast  forms  new  and  longer  pro- 
cesses. A  formation  of  new  blood  vessels  which  has  been  claimed 
by  Pfannenstiel  has  not  been  observed  by  Rossi  Doria. 

According  to  Rossi  Doria,  "the  trophoblast  corrodes  the  ves- 
sel walls  and  penetrates  them  with  the  syncytium.  In  defense  the 
maternal  tissue  protects  itself  against  the  invasion  of  the  tropho- 
blast by  means  of  a  barrier  of  decidual  cells  (Umlagerungszone). 
In  this  manner  both  the  fetal  trophoblastic  and  the  maternal  cap- 
sules are  formed." 

This  quotation  alone  proves  sufficiently  the  great  similarity  be- 
tween.Rossi  Doria's  and  my  descriptions,  yet  it  may  not  be  amiss 
to  also  point  out  the  harmony  of  our  views  concerning  the  forma- 
tion and  lining  of  the  trophoblastic  lacunae.  I  will  cite  verbatim 
his  description  (pg.  503)  since  my  observations  are  identical. 
"The  syncytium  breaks  into  the  decidual  coat  especially  into 


64       THE    TROPHOBLAST    AND    ITS    SURROUNDING    BLOOD    SPACES. 

the  perivascular  spaces  and  beneath  the  endothelium  as  well  as 
into  the  lumen  of  the  blood  vessels.  All  the  giant  cells  which 
have  been  found  by  some  observers  in  the  decidua,  in  this  stage 
of  development  of  the  ovum,  are  to  be  considered  cells  derived 
from  the  syncytium.  (Compare  my  identical  findings  in  Fig.  4). 
They  have  become  separated  from  a  pedicle  at  first  existing  and 
then  even  in  a  series  of  sections  show  the  character  of  isolated 
cells.  Often,  however,  they  remain  attached  to  the  syncytium 
from  which  they  originate,  and  then  only  by  mistake  can  be  pro- 
nounced giant  cells." 

According  to  Marchand  (pg.  262)  the  developing  ovum  reacts 
upon  the  surrounding  uterine  inucosa  like  a  malignant  growth, 
it  "eats  its  way"  into  the  mucosa  as  Graf  v.  Spec  has  demon- 
strated for  the  earliest  stage  of  the  ovum  of  the  guinea  pig. 
Other  claims  of  Marchand  need  not  be  considered  here  since 
the  ova  described  by  him  are  much  older,  two  of  them  being 
in  quite  a  defective  condition. 

The  ovum  described  by  Friolet  and  estimated  to  be  from  three 
to  four  weeks  old  also  seems  of  limited  value  in  a  consideration 
of  the  very  early  stage.  He  agrees  in  all  main  points  with  'Peters. 

Herrmann  and  Stolper  have  made  exhaustive  researches  con- 
cerning the  ovum  of  the  guinea  pig  and  have  arrived  at  the  fol- 
lowing conclusions:  "1.  In  the  guinea  pig  there  exists  but  one 
kind  of  syncytium  and  this  is  positively  fetal,  having  developed 
from  the  Anlage  of  the  placenta.  2.  There  exists  definite  rela- 
tions between  the  syncytium  and  maternal  vessels ;  and,  3.  The 
villus  of  the  placenta  of  the  guinea  pig  in  a  certain  stage  of  de- 
velopment, exactly  like  in  the  human  placenta,  shows  the  char- 
acteristic double  layer  of  epithelial  cover."  Thus  the  similarity 
between  mine  and  their  findings  is  obvious. 

Concerning  the  very  meritorious  work  of  Webster,  it  must  be 
stated  that  in  the  main  it  presents  a  clear  survey  of  all  the  findings 
which  have  been  made  in  all  the  various  months  of  pregnancy, 
but  does  not  deal  with  any  personal  investigation  of  a  new  young 
ovum. 

Beneke,  who  has  examined  a  considerably  older  ovum  (4.2x 
2.2x1.2  mm.)  with  an  embryo  1.86  mm.  long,  comes  to  deduc- 
tions which  are  identical  with  Peters'  and  those  of  mine.  In  the 
main  he  confirms  the  views  of  Van  Heukelom,  Peters,  Marchand 
and  others  concerning  the  structure  of  the  trophoblast.  He  also 
considers  the  syncytial  giant  cells  as  originating  from  fetal  ecto- 
blast.  He  did  not  succeed  in  differentiating  a  Symplasma  glandu- 
lare,  conjunctivum  and  cndothclialc  from  fetal  syncytium  as  has 
been  done  by  Bonnet.  The  synctium  displaces  the  endothelial 


THE    SYNCYTIUM.  65 

cells  of  the  dilated  decidual  blood  vessels  and  the  epithelium  of 
the  glands.    A  detailed  report  of  his  findings  is  still  outstanding. 


V. 
THE  SYNCYTIUM. 

In  the  previous  chapters,  in  describing  the  ectoblast  and  tropho- 
blast,  mention  has  so  frequently  been  made  of  the  syncytium 
that  no  doubt  can  be  left  concerning  my  own  views  of  its  origin. 

Since  the  opinions  of  most  prominent  investigators- are  still 
at  variance  on  this  point,  I  shall  once  more  consider  the  origin 
and  function  of  the  syncytium  and  shall  quote  disparaging  views 
of  others. 

In  accordance  with  Peters,  my  specimens  (Figs.  16  and  17) 
show  that  the  syncytium  forms  the  external  cell  layer  of  the 
ectoblast  and  that  it  is  first  noticed  in  this  situation.  We  have 
further  observed  that  when  the  inner  layer  of  cells  (Langhans' 
cells)  begin  to  send  out  small  excrescences  (Fig.  17  kn.)  or 
longer  processes,  (Figs.  16  and  17  tr)  these  are  covered  with 
syncytium  which  closely  follows  all  the  larger  and  largest  tropho- 
blast  columns  and  with  them  reaches  the  connective  tissue  of  the 
ovular  chamber. 

In  this  manner  the  syncytium  separates  all  the  proliferations 
of  the  trophoblast  from  the  surrounding  blood. 

Next  it  becomes  the  duty  of  the  syncytium  to  connect  the  ends 
of  the  trophoblastic  processes  with  the  adjoining  tissue,  to  corrode 
the  surrounding  vessels,  to  unravel  their  walls  and  finally  to 
open  up  more  and  more  blood  spaces  from  which  the  growing 
ovum  may  derive  its  nutrition. 

.  In  all  specimens  thus  the  syncytium  can  be  followed  from  with- 
in outwards,  from  the  ectoblast  towards  the  ends  of  the  tropho- 
blastic processes,  but  not  in  the  reverse  direction.  It  can  be 
observed  at  the  ends  of  the  short  trophoblastic  excrescences, 
which  have  not  as  yet  become  adherent,  in  form  of  those  well 
known  processes  which  vary  in  shape  but  as  a  rule  are  knob- 
like.  In  studying  these  pictures  and  comparing  them  with  others 
it  seems  impossible  to  come  to  any  .other  conclusion  than  that 
the  syncytium  is  solely  of  fetal  origin  and  that  it  forms  the  ex- 
ternal cell  layer  of  the  ectoblast  providing  for  the  growth  and 
nutrition  of  the  ovum. 

The  manner  also  in  which  the  syncytial  cells  corrode,  weaken 
and  dissolve  the  vessel  walls,  leads  us  to  but  one  conclusion,  viz : 
that  they  must  be  fetal  tissue  originating  in  the  Eianlage.  One 
can  see  how  thev  leave  the  ovum  and  advance  into  the  tissue 


66  THE    SYNCYTIUM. 

i 

but  never  take  the  opposite  direction.  If  the  latter  were  true, 
a  far  larger  number  of  syncytial  cells  would  be  found  in  the 
immediate  neighborhood  of  the  vessels  of  the  ovular  envelope. 
The  fact  that  all  trophoblastic  processes,  short  and  long,  carry 
syncytium  and  that  the  arches  of  the  trophoblastic  lacunae  are 
almost  completely  lined  with  a  syncytial  coat  can  hardly  be 
brought  into  harmony  with  Pfannenstiel's  claim,  that  the  vessel 
endothelium  is  transformed  into  syncytium  and  that  starting  from 
here  the  syncytium  gradually  proceeds  toward  the  ovum. 

Peters,  with  whom  I  agree,  expresses  the  following  precise 
views  concerning  the  genesis,  the  early  appearance,  and  the  loca- 
tion of  the  syncytium  (pg.  87.)  :  "We  occasionally,  though  rarely 
find  within  the  trophblast,  blood  lacunae  which  as  yet  are  not 
lined  with  syncytium.  Otherwise,  however,  the  syncytium  is 
found  distributed  over  the  entire  surface  of  the  ovum,  i.  e.,  in  all 
sections  of  the  complete  series  here  and  there  we  find  bands  and 
masses  of  syncytial  protoplasm  varying  in  size,  which  either  lie 
flat  on  the  trophoblast  or  are  connected  with  it  by  a  irregular  net- 
work of  protoplasm  or  lie  free  in  the  blood  lacunae  or  at  times 
push  forward  toward  the  Umlagerungszone."  On  these 
facts  Peters  declares  the  syncytium  to  be  a  tissue  of  fetal  origin 
and  my  specimens  have  forced  me  to  the  same  conclusion. 

This  seems  to  settle  the  question  whether  the  syncytium  could 
possibly  originate  from  uterine  epithelium  or  decidual  tissue. 
Peters  has  advanced  so  many  and  convincing  arguments  in  oppos- 
ing this  view  that  I  feel  unable  to  add  new  ones. 

The  following  are  some  of  the  points  in  which  my  views  have 
changed  as  a  result  of  the  study  of  this  youngest  ovum  and  are 
now  at  variance  with  views  formerly  expressed :  The  origin  of 
the  Langhans'  cells,  the  decidua  of  uterine  epithelium  in  the 
neighborhood  of  the  ovum  (already  corrected  on  a  previous  occa- 
sion), the  origin  of  the  intervillous  spaces,  and  a  few  others. 

A  further  advance  of  our  knowledge  of  this  problem  depends 
upon  the  discovery  of  more  very  young  human  ova  in  situ,  com- 
ing if  possible  from  patients  who  have  died  suddenly  but  not  as 
suicides.  These  specimens  must  be  carefully  preserved,  pains- 
takingly examined  and  the  microscopic  pictures  reproduced  in 
illustrations  which  are  true  to  nature. 


EXPLANATION  OF  FIGURES. 

Plate  I.  Fig.  1.  The  pregnant  uterus  split  up  its  anterior  wall.  The  light  spot 
marked  "ovum"  denotes  the  site  of  embedding  of  the  ovum.  o.  i.= 
Internal  Os. 

Fig.  2.  Three  microscopic  sections  demonstrating  the  mucous  membrane 
elevation  (h),  in  which  the  ovum  lies,  g  — line  of  separation  of 
mucosa  and  musctilaris.  2a  —  Section  5;  2b~  Section  80;  2c 
=  Section  160.  (Natural  size.) 

Plate  II.  Fig.  3.  Section  4.  Outer  border  of  the  mucous  membrane  elevation,  e  = 
surface  epithelium,  v  =  decidua  vera.  d  —  Dilated  and  folded  gland, 
showing  beautifully  preserved  epithelium,  c  —  Capillaries.  F  — 
Mucous  membrane  furrow.  Obj.  A  A.  Oc.  3. 

Fig.  4.  Section  10.  fi  =  Fibrin  cover,  e  =  Rests  of  surface  epithelium,  c 
=  Confluent  blood  vessels.  F  =  Furrow,  tr  =  Trophoblast  pro- 
cesses, sy  =  Syncytial  cells.  Obj.  A  A.  Oc.  3. 

Plate  III.     Fig.  5.     Section  15.     Obj.  AA.    Oc.  12. 

fi     =  Fibrin  cover. 

w    =  Rests  of  cubodial  epithelium  on  the  fibrin  cover. 

e     =  Underlying  surface  epithelium   (?). 

e.s.  =  The  same  depressed,  simulating  a  gland  opening.  (See 
Text!). 

c     =  Confluent  blood  spaces. 
Fig.  6.     Section  19.     Obj.  A  A.  Comp.   Oc.  4. 

fi    =  Fibrin  cover. 

e.s.  —  Trace  of  depression  as  seen  more  plainly  in  Fig.  5. 
(Section  15). 

c     =  Confluent  blood   spaces. 

tr   =  Trophoblast  processes. 

F  —  Mucous  membrane  furrow.  Red  blood  corpuscles  between 
the  depression,  (e.  s.)  and  fibrin  cover. 

Plate   IV.     Fig.  7.     Section  22.    .Obj.  A  A.   Oc.  3. 

fi    =  Fibrin  cover. 

e  —  From  the  edges  surface  epithelium  ( ?)  is  seen  passing 
beneath  the  fibrin  cover.  Possibly  syncytium. 

d.v.=  Decidua  vera. 

c     =  Confluent  blood  vessels. 

tr   =  Trophoblast   processes. 

F    =  Mucous  membrane  furrow. 

"ovum"  =  The  Fianlage,  laterally  cut,  is  seen  for  the  first  time. 
Fig.  8.  Section  27.  Obj.  A  A.  Comp.  Oc.  4." 

fi    =  Fibrin  cover.     To  the  right  arranged  in  folds. 

d.v.^  Decidua  vera. 

c     —  Confluent  blood  vessels. 

F    =•  Mucous  membrane  furrow. 

dr    =  Glands. 

tr  —  Several  trophoblast  processes  have  become  anchored  in 
the  periphery  of  the  mucous  membrane. 

sy    =  A   plug  with  knob-like   syncytial   processes. 

"ovum".=  Eianlage  becomes  more   distinct. 

Plate    V.     Fig.  9.      Section  26-28.     Zeiss  Obj.  A  A.    Oc.  3. 

fi     =  Fibrin  cover.    To  the  right  arranged  in  folds. 
e     =  Border  epithelium   (?),  passing  from  surface  under  fibrin 
cover.      Probably    a    band    of    syncytium     passing     from    tropho- 
blast  (tr). 
tr   =  Trophoblast  processes. 

67 


68  EXPLANATION    OF    FIGURES. 

Plate  VI.  Fig.  10.  The  left  half  of  Fig.  9  highly  magnified.  Obj.  Zeiss.  Aprochr. 
4.0  mm.  Oc.  6. 

fi    =  Fibrin  cover. 

e     =  Border  epithelium. 

tr  =  The  trophoblast  processes  are  connected  with  the  syncy- 
tial  cells,  which  might  be  mistaken  for  surface  epithelium.  (Com- 
pare Peters'  Plate  V.  Fig.  12  and  13.) 

Plate  VII.     Fig.  11.     Section  30,    Obj.  AA.    Oc.  8.    The  middle  part  of  the  Section  was 
purposely  omitted. 

fi    =  Fibrin  cover,   symmetrical  to  the  left,  to  the  right  many 
folds  present,  as  in  a  corpus  luteum.  • 
tr   =  Trophoblast   processes   terminating  in   a 
sy  =syncytial   club   shaped   ending. 

e  =  Epithelial  rests  (?).  Probably  a  band  of  syncytium  com- 
ing from  the  trophoblast  (tr). 

Fig.  12.     Section  32.     Obj.  Apochr.  4,0  mm.    Oc.  3. 
tr   =  Trophoblast  processes. 
sy  =  Syncytium. 

Fig.  13.     Section  39.     Apochr.     Obj.  4,0  mm.     Oc.  3. 
fi  —  Fibrin   cover. 

sy  —  Syncytial  bands,  terminating  to  the  right  in  a  club-shaped 
mass    of    cells, 
tr   =  Trophoblast  covered  with  (sy)  syncytium. 

Plate  VIII.    Fig.  14.     Section  37.     Obj.  A  A.    Oc.  3. 

fi    —  Fibrin    cover. 

e     =  Rests  of  surface  epithelium  (?). 

c     =  Confluent    blood    vessels. 

F    =  Mucous   membrane   furrow. 

dr  =  Glands.  The  lateral  ones  (to  the  left  and  above)  open 
into  the  cavum  uteri,  to  the  right  and  below,  into  the  furrow. 
The  middle  gland  (m)  divides  into  two  branches. 

The  right  branch  approaches  the  ovular  chamber,  but  does  not 
open  into  it. 

tr   =  Trophoblast    processes. 

sy  =  Mass  of  syncytium. 

Plate  IX.     Fig.  15.     Section  40.     Obj.  A  A.    Oc.  8. 

fi  =  The  club-like  end  of  the  fibrin  cover  showing  the  folded 
arrangement  as  in  a  corpus  luteum. 

tr   =  The  arch-like  arranged  trophoblast  can  be  traced  to  the 
epithelial-like  bands  beneath  the  club-like  end  of  the.  fibrin  cover. 
Question,  whether  epithelial  rest  or  not. 
Fig.  16.     Section  47.     Obj.   A  A.     Oc.  8. 

fi    =  Fibrin  cover  partly  undergoing  organization. 

ei     Eianlage. 

ekt  =  Ectoderm. 

tr   =  Trophoblast    processes. 

sy  —  Syncytial   buds. 
Fig.  17.     Section  60.    "Obj.  A  A.    Oc.  8.     Lettering  as  in  Fig.  16. 

k  —  Trophoblast  buds  with  a  syncytial  covering.  (See  Fig.  16. 
under  high  magnification). 

Plate   X.     Fig.  18.     Section  63.    Obj.  D.    Oc.  3. 

fi.o.=  Fibrin  covering  undergoing  organization, 
ei   =  Eianlage. 
ekt  and    EMi~=  Ectoderm, 
tr   =  Trophoblast  processes. 

a  =  Eianlage  lying  with  its  broad  surface  to  the  inner  wall  of 
the  summit  of  the  ovum. 

Plate  XI.     Fig.  19.     Section  69.     Obj.  AA.     Oc.  3. 

Kn^  The  fibrin  cover  presents  itself  in  its  right  process  as 
a  small  structureless  elevation. 


EXPLANATION    OF    FIGURES. 


69 


Fig.  20. 
Fig.  21. 

Plate  XII.    Fig.  22. 


Plate  XIII.    Fig.  23. 


Plate  XIV.   Fig.  24. 


Plate  XV.    Fig.  25. 

Plate  XVI.   Fig.  26. 
Fig.  27. 

Fig.  28. 


Section  75.     Obj.  AA.    Oc.  3. 

Kn—  The  knob-like  projection  again  becomes  longer  and  lies 
upon  the  organized  fibrin. 

s.b.  =  A  cloddy  band  covering  same. 
Section  80.     Obj.  A  A.    Oc.  4. 

fi  =  The  structureless  fibrin  cover  again  becomes  longer  and 
is  similar  to  sections  10-25. 

s.b.  =  A  cloddy  band  lying  upon  same.  Eianlage  with  numerous 
trophoblast  processes.  (Sketched). 

Section  92.     Obj.  AA.    Oc.  3. 

fi  =  The  fibrin  cover  partly  covered  by  cloddy  band,  (s.  b.) 
again  becomes  longer  and  lies  upon  the  ovular  summit. 

F  =  Mucous   membrane    furrow. 

c.  ci,  cs=  Confluent  dilated  blood  spaces. 

dr  '—  Elongated  glands  surround  the  ovum. 

tr  =  The  trophoblast  processes  are  anchored  in  the  border 
of  the  ovular  chamber  by  means  of  the  syncytium. 

Section  94.     Obj.   AA.    Oc.   6.  f 

fi  =  The  fibrin  cover  with  its  short  cloddy  band  (s.  b.),  has 
again  become  somewhat  longer  and  lies  closely  applied  to  the 
border  tissue. 

F  =  Mucous  membrane  furrow. 

c,   ci,   c-=  Confluent   dilated   blood   spaces. 

dr.  dn.  dr», =  Glands.  Those  marked  dn  and  drc  in  the 
illustration,  reach  almost  to  the  uterine  cavity.  They  are  partly 
filled  with  blood  and  toward  the  base  of  the  ovular  chamber  they 
appear  partly  displaced  and  partly  dissolved.  No  gland  is  seen 
opening  into  the  ovular  chamber. 

tr  =  Several  trophoblast  processes  are  anchored  to  the  inner 
u-;:ll  of  the  ovular  chamber. 

Section  105.     Obj.  A  A.  Oc.  8. 

The  fibrin  cover  is  no  Jonger  present. 

F   =  Mucous  membrane  furrow. 

c    =  Confluent  blood  spaces. 

dr.  dn  — Glands.  The  one  marked  dn  reaches  almost  to  the 
ovular  chamber. 

tr  =  A  number  of  trophoblast  processes  anchor  themselves  to 
the  inner  wall  of  the  ovular  chamber  partly  with  syncytial  off- 
shoots. 

Section  142.     Obj.  AA.    Oc.  3. 

c  =  Mucous  membrane  elevation  with  innumerable  confluent 
blood  spaces. 

dr  =  Four  large  glands  showing  a  partly  tortous  course  with 
opening  at  dr.m. 

bl  =  Blood  free  in  the  tissue. 

Section  52.     Obj.  4,0  mm.    Oc.  3. 

Ectoderm  highly  magnified  (See  Figs.  16,  17  and  18). 
1.  z.  =Langhans'  cells  on  the  inside. 
sy   =  Syncytial  cover  on  the  outside. 
Section  60   (See  Fig.   17)   under  low  power. 
Ectoderm  under  high  magnification. 

1.  z.  =  Langhans'  cells   forming  trophoblast  cells   and  offshoots. 
They  are  covered  externally  like  ectoderm  bands  in  Fig.  26  with 
syncytium.     Obj.  4,00  mm.     Oc.  3. 
Section  90.    Obj.  4,0  mm.    Oc.  3. 

sy  =  The  syncytial  cells  advance  from  the  trophoblast  toward 
the  wall  of  a  transversely  cut  capiliary  (ca)  and  corrode  the  vessel 
wall  (en). 


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